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Old 12-13-2003, 02:12 PM   #1
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My Dad has Parkinson's at 82 - doctor is saying he's bipolar!

I'm writing this for my dad who has diagnosed with Parkinson's at 81 years old (9 months ago). His Parkinson's progressed extremely rapidly. He doesn't have tremors, but he can barely walk (stiff, weak muscles) and he's starting to suffer from dementia.

My dad went into the hospital about 30 days ago, he developed pneumonia from aspirating on his food (he has trouble swallowing). It was touch and go there for awhile, but he was able to pull through. One of the "doctor's" there (I use that term loosely) has decided that my dad has undiagnosed bi-polar disease. He's put my dad on THREE neurological meds: Depakote which is an anti-convulstant, Abilify which is a mood-stabilizer, and Trazadone which is anti-depressant (this is along with 3 other meds for high-blood pressure).

This "doctor" is basing his diagnosis on dad's current mental condition. He's very emotional, crying at one point and then happy the next. I'm sure that this is largely due to his dementia (and I also wonder what all those neurological meds are doing to him). This "doctor" also uses dad's inability to sleep at night as an indication of "mania" (though he can sleep through the day). Hello? Even as a layperson I know that it's very common for someone suffering from Parkinson's disease to have problems sleeping at night.

All three of my dad's kids adamantly disagree with this doctor's diagnosis of "bi-polar", as well as my step-mom who's been married to him for over 10 years. This "doctor" told my step-mom that dad was able to hide his symptoms due to his intelligence and also due to the fact that my step-mom was a "stabilizing" influence. (Give me a break...if it was that easy to "hide" symptoms of bi-polar disorder, what the heck do we need any meds?).

My dad held the same job for over 50 years, my dad has never been depressed other than the normal type lows that everyone goes through in their lifetime. I've also never seen any sort of "mania" in all the years growing up with my dad. This doctor only met my dad when he was in the hospital suffering from dementia. How can he make this sort of diagnosis??? He's also a psychiatrist, not a psychologist. So he's never done any sort of psychological testing.

I don't know what to do to fight against this. My biggest concern are all the meds this idiot has my dad on. I don't know how these meds can effect Parkinson's???

My step-mom has power of attorney. Unfortunately she's of that generation that believes doctors are gods and are thus never wrong. I'm trying to fight for a second opinion. I'd like my dad to be seen by a geriatric specialist. Someone who must see a lot of dementia, a lot of Parkinsons, etc.

Does anyone know if the types of drugs I mention above can be harmful to someone with Parkinson's (especially this far advanced). And also, am I right the people with Parkinson's often times have problems sleeping at night?

Thanks so much...

 
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Old 12-13-2003, 03:27 PM   #2
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Re: My Dad has Parkinson's at 82 - doctor is saying he's bipolar!

Quote:
Originally Posted by AliAyson
I'm writing this for my dad who has diagnosed with Parkinson's at 81 years old (9 months ago). His Parkinson's progressed extremely rapidly. He doesn't have tremors, but he can barely walk (stiff, weak muscles) and he's starting to suffer from dementia.

My dad went into the hospital about 30 days ago, he developed pneumonia from aspirating on his food (he has trouble swallowing). It was touch and go there for awhile, but he was able to pull through. One of the "doctor's" there (I use that term loosely) has decided that my dad has undiagnosed bi-polar disease. He's put my dad on THREE neurological meds: Depakote which is an anti-convulstant, Abilify which is a mood-stabilizer, and Trazadone which is anti-depressant (this is along with 3 other meds for high-blood pressure).

This "doctor" is basing his diagnosis on dad's current mental condition. He's very emotional, crying at one point and then happy the next. I'm sure that this is largely due to his dementia (and I also wonder what all those neurological meds are doing to him). This "doctor" also uses dad's inability to sleep at night as an indication of "mania" (though he can sleep through the day). Hello? Even as a layperson I know that it's very common for someone suffering from Parkinson's disease to have problems sleeping at night.

All three of my dad's kids adamantly disagree with this doctor's diagnosis of "bi-polar", as well as my step-mom who's been married to him for over 10 years. This "doctor" told my step-mom that dad was able to hide his symptoms due to his intelligence and also due to the fact that my step-mom was a "stabilizing" influence. (Give me a break...if it was that easy to "hide" symptoms of bi-polar disorder, what the heck do we need any meds?).

My dad held the same job for over 50 years, my dad has never been depressed other than the normal type lows that everyone goes through in their lifetime. I've also never seen any sort of "mania" in all the years growing up with my dad. This doctor only met my dad when he was in the hospital suffering from dementia. How can he make this sort of diagnosis??? He's also a psychiatrist, not a psychologist. So he's never done any sort of psychological testing.

I don't know what to do to fight against this. My biggest concern are all the meds this idiot has my dad on. I don't know how these meds can effect Parkinson's???

My step-mom has power of attorney. Unfortunately she's of that generation that believes doctors are gods and are thus never wrong. I'm trying to fight for a second opinion. I'd like my dad to be seen by a geriatric specialist. Someone who must see a lot of dementia, a lot of Parkinsons, etc.

Does anyone know if the types of drugs I mention above can be harmful to someone with Parkinson's (especially this far advanced). And also, am I right the people with Parkinson's often times have problems sleeping at night?

Thanks so much...

I share your opinion of most doctors. I have pd and i have been through five neurologists.

I have taken trazadone to help me sleep. yes, most pwps have a problem sleeping. Based on the drugs you listed, none are parkinson drugs.

most people your dad's age are more sensitive to side effects. so in your dad's case less is better. their is someone, who is a friend, has taken care of her husband for 29 years. her screen name is googy, and her husband has dementia. she worked with her neurologist and they deleted all pd drugs except sinemet, the most effective pd drug. all of these drugs have side effects, so it is best to change or adjust his meds, depending on the side effects.

bipolar disease should be diagnosed by a specialist such as a neurologist or physciatrist. it is a catch all for people who are up and down with their symptoms.

Since your family has so many problems communicating with this doctor, drop him and see a neurologist.

i was a patient in a large hospital and all of a sudden the head shrink came in and began testing me while i was trying to eat lunch. later, i saw his diagnosis. he said i was just fearful of having surgery. i didn't know at the time i was going to have surgery.

hope this helps.

bruce

 
Old 12-13-2003, 05:16 PM   #3
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Re: My Dad has Parkinson's at 82 - doctor is saying he's bipolar!

Quote:
Originally Posted by AliAyson
I'm writing this for my dad who has diagnosed with Parkinson's at 81 years old (9 months ago). His Parkinson's progressed extremely rapidly. He doesn't have tremors, but he can barely walk (stiff, weak muscles) and he's starting to suffer from dementia.
First of all, I want to say that I'm sorry for your father's condition. It must be very hard on you and your family.
Quote:
My dad went into the hospital about 30 days ago, he developed pneumonia from aspirating on his food (he has trouble swallowing). It was touch and go there for awhile, but he was able to pull through. One of the "doctor's" there (I use that term loosely) has decided that my dad has undiagnosed bi-polar disease. He's put my dad on THREE neurological meds: Depakote which is an anti-convulstant, Abilify which is a mood-stabilizer, and Trazadone which is anti-depressant (this is along with 3 other meds for high-blood pressure).
I know that this seems weird to you, but one of the biggest problems with Parkinson's disease is the emotional side-effects that surface due to the depletion of the dopamine (and other things) in the substantia nigra of the brain. The emotional side-effects are strongly influenced by the structural problem in the brain....depression and bipolar are common in PD patients. Depakote is an anti-convulsant, yes, but anti-convulsants, aside from lithium, are the mainstay of treatment for bipolar.
Quote:
This "doctor" is basing his diagnosis on dad's current mental condition. He's very emotional, crying at one point and then happy the next. I'm sure that this is largely due to his dementia (and I also wonder what all those neurological meds are doing to him). This "doctor" also uses dad's inability to sleep at night as an indication of "mania" (though he can sleep through the day). Hello? Even as a layperson I know that it's very common for someone suffering from Parkinson's disease to have problems sleeping at night.
Yes, I agree with you that these symptoms are due to dementia, but dementia can cause mood instability and lead to a bipolar type illness which involves periods of mania. It's not that your dad is having trouble sleeping at night, it's the fact that he actually has less need for sleep....i.e. he's not tired when he's manic, so of course he's going to have trouble sleeping. Anyway, the point is, less need for sleep along with the other symptoms I'm sure the doctor screened for, is very specific for the manic episodes that can happen in dementia.
Quote:
All three of my dad's kids adamantly disagree with this doctor's diagnosis of "bi-polar", as well as my step-mom who's been married to him for over 10 years. This "doctor" told my step-mom that dad was able to hide his symptoms due to his intelligence and also due to the fact that my step-mom was a "stabilizing" influence. (Give me a break...if it was that easy to "hide" symptoms of bi-polar disorder, what the heck do we need any meds?).
Your doctor, once again speaks the truth. There is something called the mini-mental status examination which can be used to summarize the mental status of an individual. A score of 24/30 or below denotes probable dementia; however, people that are more intelligent might get 29/30 and still be demented. Why? Because they are able to compensate. The thing is, it matters how your father's performance is now compared to before.....THAT is where the difference will lie. Also, studies have shown that people who have stabilizing factors in their lives like a spouse, progress in to dementia at a much slower pace. I assure you that your doctor is not trying to pull a fast one.
Quote:
My dad held the same job for over 50 years, my dad has never been depressed other than the normal type lows that everyone goes through in their lifetime. I've also never seen any sort of "mania" in all the years growing up with my dad. This doctor only met my dad when he was in the hospital suffering from dementia. How can he make this sort of diagnosis??? He's also a psychiatrist, not a psychologist. So he's never done any sort of psychological testing.
That's just the point...your father sounds like he was a very high-functioning person. His manic/depressive episodes are a part of his dementia. Like I said before, depression and mania are very very common in dementia. Also, regarding what you said about psychologists/psychiatrists...psychiatrists are MDs....they went through 4 years of med school and 5 years of post-graduate training. THEY are the only ones that can legally make diagnoses (in adult psych at least)...psychologists are able to assess patients, and do certain aspects of psychotherapy, but they are not the ones who can prescribe drugs or diagnose things like bipolar (though they can suggest diagnoses)...
And yes....bipolar disease can show up acutely, and even if the psychiatrist didn't know your father before, as long as he is exhibiting the signs/symptoms of mania and depression now, the psychiatrist can make a diagnosis. I know you're confused, and I think that's a function of the doctor not explaining stuff to you like (s)he should.
Quote:
I don't know what to do to fight against this. My biggest concern are all the meds this idiot has my dad on. I don't know how these meds can effect Parkinson's???
Well, the big thing with parkinson's disease is that you don't want to have them on drugs that have too many of what they call "extrapyramidal" side effects....these side-effects can mimic parkinson's disease in normal patients, so you can imagine that they would worsen things in a patient that actually has the disease. Looking at the drugs the doctor put your father on, they are not drugs that are known to have extrapyramidal effects.
Quote:
My step-mom has power of attorney. Unfortunately she's of that generation that believes doctors are gods and are thus never wrong. I'm trying to fight for a second opinion. I'd like my dad to be seen by a geriatric specialist. Someone who must see a lot of dementia, a lot of Parkinsons, etc.
I'm totally with you here....get him to a geriatrician. But I'm pretty sure he or she will say the same thing. I know that this is a confusing time for you, but you have to remember the doctor is trying to help you.
Quote:
Does anyone know if the types of drugs I mention above can be harmful to someone with Parkinson's (especially this far advanced). And also, am I right the people with Parkinson's often times have problems sleeping at night?
Like I said, the drugs above aren't known for their extrapyramidal side effects (EPS)...drugs that DO have EPS are the neuroleptic drugs such as chlorpromazine, flupenthixol, etc. etc. The newer, atypical neuroleptics like: risperidone, quetiapine, olanzapine, clozapine are better in that they have less EPS, but they can still affect patients that are sensitive; however, your dad is rightly not on a neuroleptic, so the doctor is doing something right there!

As for trouble sleeping at night, that is not a symptom that is part of the PD syndrome. I'm not saying that PD patients can't have trouble sleeping...I'm just saying that it's not a characteristic of the disease like stiffness, or tremors are. Less need for sleep, elation, irritability, impulsivity, lack of insight etc. etc. are signs of mania, and I am very sure that your dad's psychiatrist screened for those. Bipolar disease and depression are the bread and butter of psychiatry...they see those things EVERY DAY of their practice.

I think for your own peace of mind, it would be a good idea to get a 2nd opinion from a geriatrician...but please don't be angry if he or she says the same thing that the psychiatrist did.

 
Old 12-13-2003, 05:43 PM   #4
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Re: My Dad has Parkinson's at 82 - doctor is saying he's bipolar!

Thanks for your response. I don't think I explained my father's situation very well. I'm not disputing the fact that my dad is certainly having mood swings now. But these just started within the last 3 or 4 months. What this doctor is trying to say is that my father was bi-polar all his life. He's saying this based on the fact that my dad has been married 3 times. My dad was married to his first wife for 5 years, my mother for 15 years, and my step-mom for the last 10 years. This doctor says that my dad must have suffered from "hypersexuality"...even though my dad never had affairs during any of his marriages (at least none of his wives knew about it if he did). Boy..if that's the basis for bi-polar then we have a heck of a lot of bi-polar people running around, Hollywood's full of 'em.

My brother has his PhD in psychology (he also disagrees with the bi-polar diagnosis by the way). My understanding of the difference between psychiatrists and psychologists is that psychiatrists actually have LESS experience with running the sort of tests that determine what sort of mental disorder someone has, and are really just an MD who's done 1 year residency in a mental health type hospital.

I guess I myself have had very bad experiences with psychiatrists. During the time that Prozac was in it's hey day and everyone was giving it out like candy, a counselor I was seeing asked if I wanted to try it (this was years ago...I was trying to get help with an eating disorder..which I've long since gotten over). I tried the Prozac (reluctantly as I don't like taking medication if I can help it). It had to be prescribed by the psychiatrist that my counselor worked with. The psychiatrist I saw was the head of psychiatry at a very well known medical school in Northern California (in the same league as Harvard and Duke). The reason I remember this guy so well is that I had to call him after being on the prozac for about 3 weeks. I had a middle ear infection (though I didn't know it at the time). All I knew was that I felt sort of "out of it" and dizzy. I wondered if it could be the prozac. I called this guy and talked to him for maybe 2 minutes about how I felt sort of dizzy and out of it (if you've ever had your equilibrium screwed up then you know the feeling). I wasn't panicky or incoherent, just concerned. This guy told me (I'm NOT making this up)..that "you sound like you are suffering from a psychotic breakdown. You should check yourself into the hospital." Give me a break! I knew that whatever was wrong with me it wasn't due to some sort of psychotic breakdown. I also realized that I felt ok when I laid down. As far as I know there's no "psychosis" that effects you only when you are standing up. But if it had been up to this doctor I'd have checked myself into a mental institution!!!!

I just don't feel like this doctor is looking at the whole picture. The risk vs. benefit analysis for one thing. My dad is 82 years old, he barely survived his last bought in the hospital. He's probably not going to live much longer. Do we really want to start messing with what's left of his brain by giving him all these powerful drugs? Also, shouldn't we try the least amount of drugs first before slamming him with 3 at the same time???

Finally, when I said that the doctor said my dad dealt with his problem all these years due to his intelligence..the doctor didn't mean his dementia which has just become very apparent within the last 6 months. The doctor was talking about my dad's supposed bi-polar which, according to this doctor who never met my father until the last 3 weeks, he's had his whole life. He's saying that none of his kids, or friends, or co-workers, or wife, or anyone close to him for that matter noticed it because my dad hid it with his intelligence. Maybe no one noticed it BECAUSE IT WAS NEVER THERE!

-- Alison

 
Old 12-13-2003, 05:49 PM   #5
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Re: My Dad has Parkinson's at 82 - doctor is saying he's bipolar!

Thanks Bruce, this helps a lot.

I too agree with your disregard for (some) doctors. I've had enough quacks in my life to know that doctors far from infallible. The best doctors I've had have been those that will admit they don't know everything and will also admit when they are wrong. Let's face it, we are all experts of our own bodies. None of us is exactly the same. A good doctor is one who really listens to his patient.

I had to laugh out loud when I read the part of your posting about the doctor who said you were afraid of surgery (which you didn't even know you were having). Gee....I guess you must have been psychic as well as fearful of surgery!

Thanks again...

-- Alison

 
Old 12-14-2003, 11:09 AM   #6
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Re: My Dad has Parkinson's at 82 - doctor is saying he's bipolar!

i totally agree with what you are saying.

yes, i have got a few laughs about the head shrink. he was very pompous and was even escorted by a female shrink. he took no more then ten minutes to "diagnose" me. i never saw him again, but his collegue stopped by a couple of times. keep in mind, everyone of those visits cost me a large consult fee.

i can prove to you that most pd patients have sleeping problems and most do not have bipolar disorder, but depression is a problem. the problem is i can't mention the name of the forum.

it never hurts to get a second opinion. actually, the ideal specialist for your dad is a MDS (movement disorder specialist, but it is difficult to get into see them and they are usually located at a university med. center, i travel 50 miles to see my MDS, and he is a good one

bruce

 
Old 12-14-2003, 06:45 PM   #7
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Re: My Dad has Parkinson's at 82 - doctor is saying he's bipolar!

Bruce told me about this concern.I think you need to take Dad to a movement Disorder specialist.W e did this many years ago.The care and meds he is getting now are not helping him.I know well about dementia my husband has had it for 9 years PD for 30 yrs.He is 81.Now in a nursing home.30 percent of PD patients develope this.The only med. that helps him is Sinemet CR. 50/200 still works,of course for the PD.

Good luck, glad you are looking out for him.

Googy
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Old 12-15-2003, 12:28 AM   #8
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Re: My Dad has Parkinson's at 82 - doctor is saying he's bipolar!

Thanks Googy. I've never heard of a "Movement Disorder Specialist". I'll have to mention this to my step-mom (and do some research myself). I'm so thankful for all the wonderful info I'm getting from this list.

I've had "Restless Leg Syndrome" all my life. I wonder if that means I'll be dealing with Parkinson's later too? I've heard that there is some link between the two.

Oh well, I'll deal with that if I have to. Thanks again.

-- Alison

 
Old 12-15-2003, 12:36 AM   #9
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Re: My Dad has Parkinson's at 82 - doctor is saying he's bipolar!

It's so scary the people who are out there acting as "counselors" to people needing help. In my experience it seems that the counselors are more screwed up then the people who go to them. I remember when I was in my early 20's and suffering from bulimea (though it wasn't really a well-known disease back then..over 20 years ago). I had such a hard time getting the courage to go see someone to try and help me. I finally made an appointment with a psychologist. I didn't even get to finish describing my condition because this counselor started laughing so hard that he started crying. He told me "I can't believe you eat all the food and then throw up". He thought it was hysterical...I was mortified. Needless to say I never went back...I got over it by myself.

Anyway, didn't mean to go off on a tangent. I wanted to thank you for taking the time to pass on the info about the Movement Disorder Specialist. And also your opinion about the bi-polar and sleeping problems. It has been a great help to me. At least I don't feel like I'm crazy.

Good luck to you and thanks again. (Though the counselor I went twenty years ago probably still does )

--Alison

 
Old 12-15-2003, 12:40 PM   #10
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Re: My Dad has Parkinson's at 82 - doctor is saying he's bipolar!

Quote:
Originally Posted by AliAyson
It's so scary the people who are out there acting as "counselors" to people needing help. In my experience it seems that the counselors are more screwed up then the people who go to them. I remember when I was in my early 20's and suffering from bulimea (though it wasn't really a well-known disease back then..over 20 years ago). I had such a hard time getting the courage to go see someone to try and help me. I finally made an appointment with a psychologist. I didn't even get to finish describing my condition because this counselor started laughing so hard that he started crying. He told me "I can't believe you eat all the food and then throw up". He thought it was hysterical...I was mortified. Needless to say I never went back...I got over it by myself.

Anyway, didn't mean to go off on a tangent. I wanted to thank you for taking the time to pass on the info about the Movement Disorder Specialist. And also your opinion about the bi-polar and sleeping problems. It has been a great help to me. At least I don't feel like I'm crazy.

Good luck to you and thanks again. (Though the counselor I went twenty years ago probably still does )

--Alison

just take the info you read with a grain of salt. googy and i are speaking from experience, but we are not doctors nor are we experts.

bruce

 
Old 12-15-2003, 04:09 PM   #11
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Re: My Dad has Parkinson's at 82 - doctor is saying he's bipolar!

I thought I had posted this. Anyway.You need to get your dad to a" movement Disorder specialist." My husband has had dementia for almost 10 yrs.PD for 30 yrs. 81 years old.He is now in a nursing home. 30 % of PD patients develope this.We saw a MDS many years go.Dont wait.

Good luck,

Googy
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Old 12-15-2003, 07:14 PM   #12
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Re: My Dad has Parkinson's at 82 - doctor is saying he's bipolar!

Yes Bruce,

I agree with you.

Googy
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Old 04-22-2005, 11:31 AM   #13
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Re: My Dad has Parkinson's at 82 - doctor is saying he's bipolar!

I use Trazodone 150mg for sleeping. I have parkinson and yes sometimes its hard to sleep. GET RID OF THE QUACK.

 
Old 04-22-2005, 12:12 PM   #14
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Re: My Dad has Parkinson's at 82 - doctor is saying he's bipolar!

My father passed away last April (which was a relief...to see him released from his pain).

We were lucky in that a newer, younger doctor took over my dad's care. She was extremely angry when she saw all the medications that this other quack put my dad on. I think the other doctor was just trying to medicate my dad so he'd be easier for the nursing home to manage. Basically just drug the h*ll out of him so he'd practically be unconsious. This younger doctor stopped all the powerful (sedating) drugs my dad was on and his cognition improved immediately. I'm so grateful that I was able to have some meaningful conversations with my dad before he died.

 
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