After surgery for what was thought to be tennis elbow, Tanja U.'s father is diagnosed with Parkinson's disease based on a positive L-dopa test.

Dopo l'operazione di un presunto gomito del tennista, al padre di Tanja U. viene diagnosticato il morbo di Parkinson a causa di un test L-dopa positivo.

In realtà è iniziato quando mio padre aveva sempre un tale dolore al gomito e poi hanno avuto la sensazione che forse era il gomito del tennista che doveva essere operato, o forse questo avrebbe fatto bene. Per molto tempo si è sempre lamentato che gli faceva male. E poi ha fatto l'operazione. E se ricordo bene, non ha aiutato molto. E poi, credo, hanno iniziato a esaminarlo ulteriormente e hanno fatto il test della dopamina. E poi gli hanno diagnosticato il morbo di Parkinson.

Test della dopamina

Après l'opération d'un prétendu tennis elbow, le père de Tanja U. reçoit un diagnostic de maladie de Parkinson suite à un test positif à la L-dopa.

En fait, cela a commencé quand mon père avait toujours des douleurs au coude et qu'on avait l'impression qu'il s'agissait peut-être d'un tennis elbow qu'il fallait opérer ou que cela servirait peut-être à quelque chose. Il s'est longtemps plaint d'avoir mal. Et puis il a fait l'opération. Et si je me souviens bien, elle n'a pas vraiment servi à quelque chose. Et puis, je crois qu'on a commencé à faire des examens complémentaires et qu'on a fait un test à la dopamine. Et après, on a diagnostiqué la maladie de Parkinson.

Test de dopamine

Nach der Operation eines vermeintlichen Tennisarms, erhält Tanja U.s Vater aufgrund eines positiven L-Dopa-Tests die Diagnose Morbus Parkinson.

Es hat eigentlich angefangen, als mein Vater immer so Schmerzen im Ellbogen hatte und dann hatte man das Gefühl, das sei ein Tennisellbogen vielleicht, den man operieren muss, oder vielleicht würde das etwas nützen. Eine längere Zeit hat er immer geklagt, dass es ihm wehtut. Und dann hat er die Operation gemacht. Und wenn ich mich richtig erinnere, hat die aber dann nicht wirklich etwas genützt. Und dann hat man, glaube ich, angefangen, weiter zu untersuchen und dann eben den Dopamintest gemacht. Und nachher kam die Diagnose Parkinson.

Dopamintest

Yolanda

It actually started when my father always had such pain in his elbow and then it was felt that it was tennis elbow maybe that needed to be operated on, or maybe that would do some good. For a long time he always complained that it hurt. And then he had the surgery. And if I remember correctly, it didn't really help. And then, I think, they started to investigate further and then they did the dopamine test. And then he was diagnosed with Parkinson's disease.

Dopamine test

The diagnosis of Parkinson's disease is made on the basis of the neurological examination findings and, if necessary, by means of imaging procedures (e.g. SPECT). A positive L-dopa test also indicates a typical Parkinson's disease. For those affected, the path from noticing the first signs to an official diagnosis of Parkinson's varies. Although, according to the literature, the first formulated diagnosis is correct in the majority of cases, patients and relatives in the early stages of the disease also report medical misjudgements, misdiagnoses and mistreatments. A prolonged uncertainty about the cause of the symptoms is experienced as difficult and the receipt of the diagnosis of PD on the one hand as devastating, but on the other hand also as a relief that there is clarity. Disputes with cost units about the assumption of diagnostic examinations are also reported.

The path to diagnosis

Parkinson's disease is a progressive neurodegenerative disease affecting both the central and peripheral nervous system. Symptoms are very heterogenous and include motor (e.g., tremor, slow movements, muscle rigidity) and non-motor symptoms (e.g., depression, sleep disturbances, anosmia). Parkinson's disease can lead to a loss of autonomy and self-esteem, altered relationships and social isolation.Communication impairment is also common and is associated with both motor and cognitive disturbances. Many people who suffer from Parkinson's disease increasingly lose their ability to work and their mobility is more and more restricted. Parkinson's disease is a challenge not only for the patients, but also for family caregivers, who must balance their own needs with caregiving responsibilities. Two important treatment options for Parkinson's disease in the advanced stage are deep brain stimulation and the Duodopa® pump. Deep brain stimulation is a brain modulation technique that works like a heart pacemaker and requires neurosurgical intervention. The Duodopa® pump consists of a continuous infusion of levodopa-carbidopa gel via a pump across the intestinal wall into the intestine.
For the DIPEx module on Parkinson's, we conducted 32 interviews with people with Parkinson's disease and family caregivers. Interview excerpts in the form of texts, video or audio clips, as well as drawings, make it possible to experience how the disease and its therapy affect the daily lives of those affected and their relatives.

La malattia di Parkinson è una malattia neurodegenerativa progressiva che colpisce il sistema nervoso centrale e periferico. I sintomi sono vari e comprendono sintomi motori (ad esempio tremore, movimenti lenti, rigidità muscolare) e non motori (ad esempio depressione, disturbi del sonno, anosmia). Il morbo di Parkinson può comportare una perdita di autonomia e di autostima, alterazione delle relazioni e isolamento sociale. Anche i disturbi della comunicazione sono comuni e sono associati a disturbi motori e cognitivi. Molte persone con malattia di Parkinson sono sempre più limitate nella loro capacità di lavorare e nella loro mobilità con il progredire della malattia. La malattia di Parkinson rappresenta una sfida non solo per la persona affetta, ma anche per i familiari che la assistono e che devono trovare un equilibrio tra le proprie esigenze e quelle del paziente.
Due importanti trattamenti clinici attuali per la malattia di Parkinson avanzata sono la stimolazione cerebrale profonda e la pompa Duodopa®. La stimolazione cerebrale profonda è una tecnica di modulazione dell'attività cerebrale che funziona in modo simile a un pacemaker e richiede un intervento neurochirurgico. Con la pompa Duodopa® , un'infusione continua di un gel di levodopa-carbidopa viene erogata tramite una pompa attraverso la parete intestinale nell'intestino tenue.
Per il modulo DIPEx sulla malattia di Parkinson, abbiamo condotto interviste con 32 persone affette da Parkinson in fase avanzata e con i loro familiari. Gli estratti delle interviste, sotto forma di testi, video o clip audio e disegni, mostrano come la malattia e la sua terapia influenzino la vita quotidiana delle persone colpite e dei loro familiari.

Malattia di Parkinson: stimolazione cerebrale profonda e pompa Duodopa

La maladie de Parkinson est une maladie neurodégénérative progressive touchant plusieurs régions du système nerveux central et périphérique. Les symptômes divers comprennent des symptômes moteurs (p. ex. tremblements, mouvements lents, rigidité) et non moteurs (p. ex. dépression, troubles du sommeil, anosmie). La maladie de Parkinson peut entraîner une perte d'autonomie et d'estime de soi, une modification des relations et un isolement social. Les difficultés de communication sont également fréquentes et sont associés à la fois aux troubles moteurs et cognitifs. De nombreuses personnes atteintes de la maladie de Parkinson se voient restreintes dans leur mesure de travailler ainsi que dans leur mobilité au fur et à mesure que la maladie progresse. La maladie de Parkinson présente un défi non seulement pour les patient·e·s, mais aussi pour les proches aidants, qui doivent concilier leurs propres besoins et leurs responsabilités en matière de soins. Pour les formes graves de la maladie de Parkinson, les deux principaux traitements sont actuellement la stimulation cérébrale profonde et la pompe Duodopa®. La stimulation cérébrale profonde consiste à moduler l'activité cérérbrale tel le ferait un pacemaker pour le cerveau, impliquant une intervention neurochirurgicale. La pompe Duodopa® consiste en une perfusion intrajunale continue de gel de lévodopa-carbidopa via une pompe traversant la paroi intestinale.
Le module DIPEx sur la maladie de Parkinson rapporte les expériences de 32 personnes qui soit sont atteintes de la maladie de Parkinson et ont été traitées par stimulation cérébrale profonde ou par la pompe Duodopa®, soit sont des proches aidants. Des extraits d'entretiens sous forme de texte, de vidéo ou de clip audio, ainsi que des dessins donnent un aperçu de la façon dont la maladie et son traitement affectent le quotidien des personnes atteintes de la maladie de Parkinson ainsi que celui de leurs proches.

Maladie de Parkinson : stimulation cérébrale profonde et pompe Duodopa

Morbus Parkinson ist eine fortschreitende neurodegenerative Erkrankung, die das zentrale und periphere Nervensystem betrifft. Die Symptome sind vielfältig und umfassen motorische (z.B. Tremor, langsame Bewegungen, Muskelstarre) und nicht-motorische Symptome (z. B. Depression, Schlafstörungen, Anosmie). Morbus Parkinson kann zu einem Verlust an Autonomie und Selbstwertgefühl, veränderten Beziehungen und sozialer Isolation führen. Kommunikationsstörungen sind ebenfalls häufig und sowohl mit motorischen als auch mit kognitiven Störungen verbunden. Viele Menschen mit Parkinson sind im Verlauf der Krankheit zunehmend in ihrer Arbeitsfähigkeit und ihrer Mobilität eingeschränkt. Eine Parkinson-Erkrankung ist nicht nur für die Betroffenen selbst eine Herausforderung, sondern auch für betreuende Angehörige, die ein Gleichgewicht zwischen eigenen Bedürfnissen und den Bedürfnissen der Patienten finden müssen.
Zwei wichtige aktuelle klinische Behandlungen der fortgeschrittenen Parkinson-Krankheit sind die tiefe Hirnstimulation und die Duodopa®-Pumpe. Die tiefe Hirnstimulation ist eine Technik zur Modulation der Hirnaktivität, die ähnlich wie ein Herzschrittmacher funktioniert und eine neurochirurgische Intervention voraussetzt. Bei der Duodopa®-Pumpe erfolgt eine kontinuierliche Infusion eines Levodopa-Carbidopa-Gels via eine Pumpe über die Darmwand in den Dünndarm.
Für das DIPEx Modul zu Parkinson haben wir Interviews mit 32  Menschen, die in einem fortgeschrittenen Stadium an Parkinson erkrankt sind und betreuenden Familienangehörigen geführt. In Interviewausschnitten wird in Form von Texten, Video- oder Audioclips sowie anhand von Zeichnungen erfahrbar, wie sich die Krankheit und deren Therapie auf das tägliche Leben der Betroffenen und deren Angehörigen auswirkt.

Parkinson-Erkrankung: Tiefenhirnstimulation und Duodopa-Pumpe

Parkinson's disease: deep brain stimulation and duodopa pump

Kristina

When Tanja U. learns that her father has Parkinson's disease, she still reacts relatively calmly.

For my father it was certainly bad, for my mother too. For us children, yes, it didn't mean that much. So you knew, "okay, this is a bad disease, it's getting worse and worse," but my father's current condition was still good. You didn't notice anything yet. So nothing changed in one fell swoop.

Not everything changes at once

Receiving a diagnosis of Parkinson's disease is a drastic moment. Affected people and relatives report that it pulls the rug out from under their feet and that they need time to process the news of the diagnosis. The fact that the disease is progressive can lead to an initial relief when one does not yet notice much of the symptoms and they develop slowly. In the same way, however, the fact of progression is also perceived as threatening because it is hopeless and the future is unknown. An approachable and open way of medical communication and detailed information about the disease and its treatment options are important, but do not take place for everyone.

Tanja U.

Dopamine test

Video Interview

Related experiences

Other experiences by Tanja U.

Tanja U.