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Parkinson's disease is due to the reduction in the production of dopamine, which is a neuro-transmitting chemical. And what this means is that the body, unfortunately, is lacking that chemical that is involved in movement. That chemical works in conjunction with another chemical called acetylcholine and they work on opposites. So dopamine dopes and acetylcholine excites. So what this means is that the two chemicals are equal in our body normally, that dopamine dopes and acetylcholine excites. So if I want to point my finger, what has to happen is the acetylcholine comes into play, it excites the nerves and tells the muscles to tone so I can lift the weight of my arm. When I want to put my arm back down again, the dopamine comes into play, relaxes the nerves, tells the muscles, "Relax," so that I can actually put my arm back down. So these two chemicals are constantly switching to enable every movement that we make, even for me to be able to do that. Unfortunately, in Parkinson's or idiopathic Parkinson's disease, you are not producing as much dopamine.

So you have an inequality. You have a predominance of acetylcholine and not enough dopamine to fully cancel out that message. So that means the predominance of the excitatory chemical, hence why some people will shake and some find movement very, very stiff, their muscles are very, very stiff and toned. So that potentially is the background in terms of idiopathic Parkinson's disease. It is often referred to as the triad of symptoms. So we are looking at tremor, bradykinesia, "brady," means slow, "kinesia," movement. And rigidity. They tend to be, as they say, the more common triad of symptoms. There are other symptoms as well that we look for. In terms of posture, that tends to be simian in nature. Simian, means monkey-like, so it is slightly stooped, slightly bent. Walking also tends to be short stride, so shortened gait, which then can lead to shuffling. There tends to be a lack of arm swing on the affected side, which can impact on balance. So there are numerous presentations in terms of the signs and symptoms of Parkinson's.

So in relation to the tremor, this tends to be one-sided and it tends to affect an arm or a hand. It tends to be also pill roll in nature and by that, we actually mean pill roll as in, pill-rolling the thumb and the forefinger. And as I say, it tends to be... It will be one-sided. Tremor can affect both sides as the condition progresses. As far as rigidity goes, rigidity is felt predominantly legs and arms, getting out of a chair, rolling over in bed. Although this sort of thing as well also relates back to the fact that with Parkinson's disease and the depletion of dopamine production, it affects what we call our learned voluntary movement. So that is everything we've learned to do from when we are knee-high to a grasshopper. If we think back to when we were a baby, the first movement that we learn that becomes a learned voluntary movement is actually rolling over. This is why the majority of people with Parkinson's actually have a difficulty rolling over in bed.

So all those sorts of movements that we have learned and that are voluntary and we don't have to think twice about, it is almost that we make a computer program in our head so we do not have to think twice about actually executing those movements. Unfortunately, that is what the chemical imbalance effects. So that is why people have a difficulty with learned voluntary movements because that computer program is no longer the same. Because it was originally made when the two chemicals were equal. Now those two chemicals are unequal, that program is defunct and therefore needs re-establishing. Movement becomes much slower in not only walking but every sort of movement that we make. And more difficult, potentially, because of the rigidity. Now this is where obviously rigidity comes in as well with the triad of symptoms and rigidity tends to affect, again, all our movement. And it can affect what we call our fine movement.

So we are talking fine finger movement. This is where difficulties come with writing, with fastening buttons, small buttons in particular. Shirt buttons are quite a big one. Tying shoelaces, doing buckles, any sort of fiddly jobs, they can also be immensely affected. So that is just an example of some of the motor skills that can be affected. But also there are non-motor symptoms. So these include things like dripping of saliva, a reduction in the sense of smell and taste, constipation, sleep disturbances, more so what we call REM sleep disorder, weight loss, depression and anxiety, tiredness, memory problems and hallucinations.

A slowness of movement is one of the main things because you cannot do anything in a hurry and people generally in the world are in a hurry. So you are holding them up and people get irritated. And also one of the other things is my dexterity is quite bad, so I tend to cut people off on the phone [chuckle] because I get a spasm in my hand and it cuts the phone off.

Getting out of bed is terrible. Overnight you sort of stiffen right up and then trying to get out of bed in the morning it is not very good. I am lucky, I have got a silk sheet that I got from social services. They issued me with one and that helps me just turn over in bed. But sometimes I have to... I roll out of bed and I kneel the floor and I get up, like that. And then I am... Sort of ten minutes, quarter of an hour before I can work properly. And once I take my tablets, I am fine. I do about half an hour's exercise every day in the morning. This is my first thing when I get up is to do my exercises because I find they are so helpful and they help me during the day as well. But that's one of the issues.