Living well with Parkinson’s disease

By Jay Nachman

that it will progress slowly.” neurons to die.

Parkinson’s disease is not a death sentence, and it will not initially lead to use of wheelchair or walker.

One million people in the United States are living with Parkinson’s disease, and nearly 90,000 new diagnoses are made each year, according to the Parkinson’s Foundation.

With early diagnosis and treatment, Parkinson’s disease can be managed for many years and even decades, said Dr. Tsao-Wei Liang, associate professor at Thomas Jefferson University and medical director of the Jefferson Comprehensive Parkinson’s Disease & Movement Disorders Center.

“The lifespan is generally not shortened by very much in someone with the most classic tremor dominant form of Parkinson’s,” Dr. Liang said. “Meaning when tremors are present, it tends to suggest

“In an otherwise healthy person in their 50s, 60s or 70s even, 10 years of good function with medication is certainly achievable,” Dr. Liang said. “If you’re playing tennis, we’re going to do everything we can to try and keep you active and playing tennis. If you’re taking daily walks, there is no problem with that.”

The National Institutes of Health’s National Institute on Aging (NIA) describes Parkinson’s disease as “a brain disorder that causes unintended or uncontrollable movements, such as shaking, stiffness and difficulty with balance and coordination.”

Parkinson’s disease occurs when nerve cells in the area of the brain that controls movement become impaired and/ or die, according to NIA. Normally, these nerve cells, or neurons, produce an important brain chemical known as dopamine. When the neurons die or become impaired, they produce less dopamine, which causes the movement problems associated with Parkinson’s disease. Scientists still do not know what causes the

Dr. Liang said a common treatment for Parkinson’s disease is to replace dopamine in patients and provide other, supplemental medications that can reduce symptom fluctuation and control tremors.

Although genetics and environmental circumstances may play a role in someone getting Parkinson’s disease, the biggest risk factor is simply age. “The inflection point happens to be around age 60-65, and the numbers increase steadily from there,” Dr. Liang said.

Although it’s not true for every patient, one of the first symptoms of the disease is a tremor. But the hallmark of the disease is called bradykinesia or “slowed movements.”

“There’s a deliberate or slow quality of movement,” Dr. Liang said. “One side of the body may not move as readily as the other. The side of the body or the part of the body that’s affected may become stiff or rigid.”

There are also secondary characteristics that can lead someone to a Parkinson’s diagnosis, which include loss of facial expression, bent posture, shuffling of feet when walking or even loss of sense of smell – all of these can be early warning signs of Parkinson’s disease.

Ongoing research at Jefferson and other institutions is edging ever closer to finding the cause of Parkinson’s, as well as more effective treatments.

“One of the hottest areas of research for us is [leading to when] we can finally dig in and say, ‘It’s not some kind of random bad accident that occurred or bad luck’,’” Dr. Liang said. “If we start to look at our genome and understand why someone develops Parkinson’s disease from a molecular standpoint, we’ll have better targets for treatment in the future. And that’s already happening.”

While there is no cure for Parkinson’s disease, Dr. Liang assures new patients, “It’s going to be okay. There’s a lot of research and new treatments on the horizon.”

For more information about Parkinson’s disease, contact the Parkinson’s Foundation at parkinson.org.

Information provided by Pennsylvania Department of Human Services

Anyone currently enrolled in Pennsylvania’s Medicaid program, also known as Medical Assistance (MA), should make sure their contact information is correct so they can receive timely updates about their benefits. Under new federal law, continuous MA eligibility will be separated from the public health emergency and will end on April 1. By keeping contact information up-to-date, recipients of MA will receive timely, necessary updates about their coverage and benefits, so they are ready when it is time to renew their coverage.

These changes come following passage of the federal Consolidated Appropriations Act of 2023 and will force states to resume normal MA renewal determination processes after April 1.

“Recent federal law changes Medicaid renewal guidelines, and we need everyone to know what they need to do to stay covered,” said Pennsylvania’s Department of Human Services (DHS) Acting Secretary Val Arkoosh. “In order to keep as many Pennsylvanians covered as possible, DHS needs the most accurate information available in our system so that when it is time to complete their annual renewal, Pennsylvanians can submit their renewal quickly and easily. Take the time now to ensure that your information is correct so when your renewal is due, you have what you need to avoid a potential disruption in coverage.”

Outreach to MA recipients has already begun and will continue to include mail, text, email and phone calls to make certain beneficiaries are aware of the federal action affecting their benefits.

Changes to federal policy

The federal public health emergency in response to the COVID-19 pandem- ic allowed for individuals to continue to remain enrolled in MA, even if they became ineligible based on regular eligibility criteria. This is also known as the MA continuous coverage requirement. On December 29, 2022, President Biden signed the Consolidated Appropriations Act of 2023 into law, which affects continuous MA coverage requirements.

No one will lose their health coverage without having an opportunity to complete a renewal, which will be completed over 12 months. Renewals due in March 2023 will be the first affected by the end of continuous coverage. If a person is found ineligible for the current coverage or does not complete their renewal on time, their MA coverage will end. Pennsylvanians who are no longer eligible for MA will be referred to other sources of affordable medical coverage, like Pennie – Pennsylvania’s health and dental insurance marketplace, so they have no lapse in quality, affordable health care.

Prepare for renewals

Information about when a person’s annual renewal is scheduled can be found online at dhs.pa.gov/compass or on the myCOMPASS PA mobile app. Beneficiaries without computer or mobile access can call DHS’ Customer Service Center at 215-560-7226, weekdays, from 8 a.m. to 4:30 p.m.

Pennsylvanians whose contact information or personal circumstances have changed can use COMPASS to make the following updates to their case file at any time:

• Number of people living in your household.

• Email address.

• Phone number.

• Mailing address.

COMPASS also allows users to sign up to receive e-notifications about their benefits. Keeping information up to date will help Pennsylvanians receive reminders about their annual benefit renewal quickly, so they can prevent an avoidable lapse in coverage or services. Additionally, DHS encourages Pennsylvanians to opt-in to text messages to receive information about their benefits.