The Tremor – Many people believe this to be the tell-tale sign of Parkinson’s. I am at least grateful that my tremor is hardly noticeable most of the time. In fact, if I check myself right this minute, there is no noticeable tremor in either hand, although my right hand does shake when I clench my fist. Luckily the clenched fist is not a very common position, I am pleased to say, as I am not a prizefighter. Interestingly I do boxing once a week but don’t notice a tremor when I am hitting something with gloves on…but I will check for it next week.
As this table shows from research in the Parkinson’s Journal of Research*, a tremor is clearly the most common symptom and is evident as a ‘primary priority’ in more than 15% of responses. It is however, not the only or even the necessarily the dominant symptom in many patients. For me, it is the scale and breadth of the symptoms that is the most noticeable thing.
Although the cause of Parkinson’s is still far from agreed, it is a disease that attacks the central nervous system in the brain, what I now see as its operational command center, and the chemical dopamine, which I see as its key communication tool that clearly leads to such a huge variety of symptoms.
Digging into the survey in more detail, you also see that the notable symptoms vary with the length of time the person with Parkinson’s has had the disease – i.e., its progression. It seems that the further from diagnosis, the less the tremor is the dominant symptom. As you can see from the table below, for a person who has had Parkinson’s for 11 or more years, the tremor is the 9th most dominant symptom.
Of course, that doesn’t mean the tremor magically disappears in people who have it – it just starts getting lower down the list of numerous symptoms. Other symptoms ‘catch up’.
With me, it is clearly my DNA to skip the line…
People who know me, know I am a very impatient person, and I don’t say that as a good thing. I am also often impulsive. It has led to many an amusing but at best unfortunate and regretted story, such as deciding to sell our second car in the morning (loved and cherished by my wife with even a pet name) and then seeing the reaction as my wife came home from work in the afternoon and saw it being driven off by the person who took it as a trade-in. Honey – I am sorry…again…
In the case of my Parkinson’s, it seems I am on a ‘fast track’ setting, which is why the pump was clearly given to me at a relatively early stage. My symptoms most closely match the profile of the ones evidenced in the profile of the 11+ year symptoms – balance & falls, walking (shuffling), sleep problems, freezing, elements of movement**. That of course doesn’t necessarily mean it will follow any specific trajectory – predicting the unpredictable is often a wasted effort.
Parkinson’s is a challenge because the symptoms are so multi-faceted and often different in every patient in their balance. Casual observation does not even begin to do justice to the multitude of symptoms a person may be dealing with in different parts of the body or psychologically/mentally.
It is one of the reasons, in my view, why the disease is at times underestimated in the damage it causes, mis or late diagnosed, and yet feared for its varied impacts and degenerative nature. It is a fierce enemy that seems to have ways of striking with multiple weapons.
It is an enemy to be feared and respected but nonetheless fought tooth and nail. As Sun Tzu is famous for saying, you need to know your enemy – as he said:
“If you know the enemy and know yourself, you need not fear the result of a hundred battles. If you know yourself but not the enemy, for every victory gained you will also suffer a defeat. If you know neither the enemy nor yourself, you will succumb in every battle.”
So no, I don’t have a noticeable tremor, for which I am grateful, but it is not the only sign of PD and it is important that there is awareness of this.
*Port RJ, Rumsby M, Brown G, Harrison IF, Amjad A, Bale CJ. People with Parkinson’s Disease: What Symptoms Do They Most Want to Improve and How Does This Change with Disease Duration? Journal of Parkinson’s Disease. 2021;11(2):715-724. doi:10.3233/JPD-202346
** defined as movement, mobility, fluid movements, move freely, move normally, getting out of chair, motor function, moving in confined spaces, flexibility, upper limb movements, control of my legs, hanging arm, right leg, restricted movement, lack of foot dorsiflexion, overgripping, body control
