Parkinson’s Disease is a degenerative neurological disorder that affects approximately 500,000 people in the United States. An estimated 50,000 new cases are reported each year. It has garnered much attention in recent years due to the public disclosure of well known figures such as Muhammad Ali and Michael J. Fox to be sufferers of this disease. Much research is currently underway to understand Parkinsonism.
Parkinson’s Disease affects the area in the brain called the substantia nigra. This region produces the neurotransmitter called dopamine, the chemical messenger crucial for muscle movement. Degeneration of the substantia nigra leads to decreased levels of dopamine. A cardinal symptom associated with Parkinson’s Disease is the trembling of hands. There are however other earlier symptoms associated with Parkinson’s Disease that are often ignored. These include feeling unusually anxious, irritable, fatigued and have difficulty in sleeping. As the disease progresses, patients may also experience increased and often times uncontrollable trembling, slurring of words, slowed movement (bradykinesia), stiff trunk and limbs, less facial expression, trouble swallowing, and problems with balance and coordination. Reasoning ability is for the most part, unaffected.
Diagnosis for Parkinson’s Disease is made through careful observation by the physician. There is no laboratory test that can definitively diagnose for Parkinson’s Disease. There is also no cure for Parkinson’s Disease. A common medication prescribed is levodopa, or L-dopa. L-dopa is a precursor to dopamine. The brain breaks down L-dopa to replenish the low levels of dopamine. To some, the effects of this drug is almost immediate. However, L-dopa does not reverse or stop the deterioration of the brain cells and increased dosage of L-dopa is eventually inevitable. Regular exercise and a well-balanced diet is also strongly recommended.
The exact cause of Parkinson’s Disease is unknown but is believed to be multifactorial. Genetics is strongly suspected in some cases, but it is generally thought that something must trigger it. Parkinson’s may be triggered by chemicals in the environment or even viral infections. It affects males more than females and has been found to occur in certain families, but a majority of cases are sporadic. Families with high incidence of Parkinson’s Disease are strongly encouraged to undergo genetic counseling and a comprehensive pedigree analysis to rule out a genetic cause for this disease. In families where Parkinson’s Disease only occurs in a specific gender, a new genetic test may be beneficial. Preimplantation Genetic Diagnosis (PGD) tests for genetic abnormalities and can determine an embryo’s gender prior to implantation. This can significantly reduce the chance of having an affected child in these cases. A genetic counselor should be consulted whether PGD will be beneficial. PGD is also available for a variety of other hereditary disorders.
Causes of infertility can be categorized in two ways:
Those which can be treated by medication.
Those which can be corrected only by a surgical procedure.
A special category of surgery was developed called Infertility Surgery. Infertility surgery is different from usual abdominal surgery in several specific and important ways:
It is usually limited to the pelvic area.
It involves parts of the reproductive organs.
It should be corrective in nature, not destructive or extirpatory.
Organs and their parts are removed only if absolutely necessary. Once removed they cannot be replaced.
Infertility Surgery should be as atraumatic as possible. The organs must be handled gently and with care.
Many abnormalities caused by various diseases can be successfully corrected by an experienced surgeon, thus accomplishing two goals simultaneously: treating the disease and enabling a patient to conceive one or more children the "old-fashioned" way, without the need of In Vitro Fertilization IVF or GIFT. If done improperly, however, surgery could make the underlying problem worse. It is important that an operating microscope and special instrumentations are used to work with utmost care and precision.
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