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JFK's Parkinson's Disease Center - FAQ

Comprehensive Clinical Care from two Nationally Recognized Institutes

What is Parkinson's Disease?
Parkinson's disease (PD) is a chronic, progressive neurodegenerative disease involving both motor and non-motor symptoms.  PD affects more than 1 million people in the United States.  Although PD is diagnosed primarily in the 60+ age group, a growing number of cases, known as "early onset PD" are diagnosed as early as in the 30s. In its advanced stages, PD can have a significant impact on a person's quality of life as well as that of their families.  

What are Common Parkinson's Symptoms?
The most common Motor symptoms of Parkinson's disease are shaking of the hands, extremities, face and jaw, known as resting tremor; slowness and difficulty of repetitive movement, known as bradykinesia; difficulty with balance and coordination, known as postural instability and muscle stiffness, known as rigidity.  A number of telltale Non Motor symptoms include difficulty speaking, swallowing and sleeping, loss of smell, constipation, depression, fatigue and memory loss.  

What Symptoms can Point to an Early Diagnosis of Parkinson's disease?
Because symptoms of Parkinson's disease is shared with many other conditions, it is critical that the doctor making the diagnosis is an expert in the field of neurology and movement disorders. The first step in diagnosing Parkinson's disease is a full neurological examination. Your JFK physician examination will thoroughly evaluate movement, balance and order appropriate tests to diagnose the condition and help rule out other similar presenting conditions.  Sometimes, patients exhibiting Parkinson's-like symptoms may be diagnosed with other conditions. The Neuroscience Institute also was among the first three centers in New Jersey to employ the DaTscan™, a highly sophisticated imaging modality that assesses the dopamine transporters (DaT) as dopamine is believed to play a major role in the development and course of Parkinson's disease.  While there is no test that will positively identify PD, there are numerous protocols to eliminate other conditions as quickly as possible to provide proper treatment.  

What is The Medical Management of PD?
Once properly diagnosed, you may be asked to begin medication management.  One's individual reaction to the type and dose of PD medication must be closely monitored.  In some cases, administration of the proper drug may almost immediately lessen the symptoms.  Some patients may go through a number of trial medications until your symptoms are optimized.  JFK's clinicians will soon monitor changes in symptoms using the criteria for the Parkinson's Outcomes Project (POP), established by the National Parkinson's Foundation (NPF), "which measures variations in treatment and patient outcomes to approximate best-practice in patient care".

What is the role of Dopamine in PD?
Dopamine cells are the chemical messengers between the brain and your body.  For people with Parkinson's, dopamine-producing nerve cells in the brain break down and eventually die.  The loss of dopamine results in abnormal brain activity, which in turn produces many different symptoms.  For many years, doctors and scientists have been actively searching for a way to reverse or stop the loss of dopamine.  Unfortunately, the research has yet to come up with the exact cause(s) of PD, thereby thwarting efforts to find the cure.  In the meantime, many medical, surgical and physical advances have proven to lessen the effects of PD, leading to a better quality of life for patients.

What is the Role of Rehabilitation?
Depending on an individual's needs, the care plan can encompass nearly every outpatient therapy offered at the Johnson Rehabilitation Institute (JRI).  Popular programs include LSVT BIG® and LSVT LOUD® programs. The evidence-based LSVT BIG® initiative is a four-week program in which participants meet four times a week to learn how to use bigger movements automatically in daily living. Recent research studies conducted at JFK Johnson Rehabilitation Institute have demonstrated significant improvement in PD symptoms with LSVT BIG.  In addition, JRI uses traditional physical therapy methods for postural evaluation and gait/balance enhancement and training.  LSVT LOUD®, conducted by the JFK Language Pathologists, is an effective program intended to teach patients how to speak louder and with better articulation, which can be challenging for patients with PD. JFK Johnson Rehabilitation was the first institution to offer LOUD FOR LIFE, a weekly "group" refresher designed to maintain voice loudness following the 16-day LSVT program. To ensure that each PD patient is progressing to their full potential, JRI conducts a monthly PD clinic staffed by physiatrists, physical therapists and speech therapists.  

What are the Surgical Options for PD?
JFK Neuroscience Institute is one of only a few New Jersey Parkinson's Disease Centers that performs Deep Brain Stimulation surgery (DBS).  DBS can be highly effective in reducing or even eliminating the effects of certain motor symptoms such as tremors or, in advanced cases, uncontrolled involuntary muscle movement (dyskinesia).  Another option is Carbidopa/Levidopa Enternal Suspension (Duopa).  Patients must meet certain criteria to qualify for these procedures.

What is the Importance of Exercise?
Besides taking the proper medications at the proper time, the single-most important chance one has to potentially alter the course of the disease and live a longer and healthier life with Parkinson's disease is to exercise regularly.  JFK's trained physicians and therapists will guide the way, but it is up to the patient, to value this vital information and stay active.   Your daily routine must include walking, as a minimum.  Climbing stairs, stretching and maintaining good posture are just as important as bicycling, yoga, Pilates and floor exercises.  LSVT BIG is a good start, but one must keep it up every day.  If one does not have the initiative to exercise on their own, health clubs and fitness centers exists which can also serve to enhance socialization.  In addition to a comprehensive fitness center offering yoga and other group classes JFK has introduced non-contact Rock Steady Boxing (RSB) to enhance its already comprehensive exercise programs.  Rock Steady's slogan, "Never Give Up" and "Keep Fighting" will be adopted by JFK's Parkinson 's disease Center!  Rock Steady Boxing programs' proven benefits are well matched to the entire spectrum of physical therapy for people with Parkinson's.

Why Turn to JFK?
The diagnosis and treatment of Parkinson's disease is most effective when one team of movement specialists and rehabilitative experts work together in an interdisciplinary setting treats patients.  JFK's Parkinson's Disease Center, located in Edison, NJ is uniquely qualified to offer all of the Parkinson's patient's needs in one hospital.  The JFK Neuroscience Institute works hand in hand with JFK Johnson's Rehabilitation Institute in order to accurately diagnose whether or not one has PD and to create and coordinate a complete care plan to meet the expectations and specific symptoms presented by each individual patient.  Unlike most other PD treatment programs, the entirety of JFK's Award Winning Parkinson's Disease Center is co-located right at JFK Medical Center to maximize your convenience and outcome.

What are additional JFK Services for PD Patients?
Additional services at JFK Johnson available to the PD patient include traditional physical therapy, occupational therapy, speech therapy, swallowing assessment and treatment, orthotic services, clinical psychologists, cognitive assessment and treatment, and acupuncture. Diet and Nutrition clinicians are also available to guide patients through a healthy diet and timing of medications that that optimize effectiveness. Expanded hours are in place to satisfy increased patient demand.

Can you detail Available Parkinson's Outreach?
Professional education and community outreach also are major components of the work of both the Neuroscience Institute and the Johnson Rehabilitation Institute, which holds an annual conference for physicians and participates in a number of awareness and advocacy programs.

JFK treats hundreds of Parkinson's patients, and we believe that having and understanding information about the disease can mean the difference between tolerating the disease and outsmarting it.  PD patients can and do learn from others who have the disease.  JFK provides informational outlets such as monthly support groups for patients and their care partners, community lectures, biannual professional seminars that include some of the best speakers in the world in the area of Parkinson's disease, an annual bus trip to NYC to participate in The Parkinson's Unity Walk, raising money for Parkinson's Research.  Other functions include accredited professional Continuing Educational Credits (CEU) symposiums and conferences, Parkinson's patient art shows and participation in the Michael J. Fox Partners in Parkinson event in NYC.  JFK will also provide its PD patients with National Parkinson's Foundation published pamphlets, data sheets and emergency kits in both English and Spanish. JFK's PD outreach stretches well beyond its traditional primary, secondary and tertiary catchment areas.   JFK also posts essential PD service dates on the National Parkinson's Foundation's calendar.

Does JFK Participate in Parkinson's Research?
Yes. JFK's Neuroscience and Rehabilitation Institute's neurologists, physiatrists and therapists also are investigators in numerous PD-related trials, including one examining sleep disorders in Parkinson's and neuro-ophthalmologic aspects of the disease. JFK's physical therapists and speech therapists are currently performing important research in the area of LSVT BIG and LOUD.  Ongoing PD-related research plays an important role in the quality of care of JFK's patients and, someday soon, the discovery of a cure for this quixotic disease.  

At JFK, we are always at the cutting-edge of Parkinson's diagnosis and treatment, and we are constantly "upping our game" to maintain that reputation.  The Institute is a member of the Parkinson's Study Group, the largest, not-for-profit research network of Parkinson's centers in North America.