“Ask the Doctor” with Rebecca Gilbert
Q: My husband has PD and has excessive sweating, to the point that he doesn’t want to go out anymore. He needs to change clothes multiple times during the day and night. What can be done?
A: Excessive sweating can be a very difficult symptom of PD. Here are some strategies to try to manage it:
- Moisture wicking materials that absorb sweat and then dry easily
- Prescription-strength deodorant
- Botulinum toxin injections in key areas like hairline or palms to reduce sweating
- Topical glycopyrrolate — This is a gel containing an anti-cholinergic medication that can be applied to areas that are typically sweaty. The medication can have side effects. However, a topical medication is thought to have fewer side effects than an oral pill.
- Oral medications — Despite potential side effects, oral anti-cholinergics (such as oral glycopyrrolate) may be appropriate for certain people with PD.
- A variety of procedures are available to reduce sweating. These include:
- Iontophoresis — a medical device that applies a current across the skin that increases the permeability of the skin, or the ability of substances to pass through the skin, used primarily for the hands and feet.
- MiraDry — a handheld device that delivers microwave energy to specific areas of the body, thereby destroying the underlying sweat glands.
- Laser treatments
Q: My husband with PD was in the hospital for a urinary tract infection and then was sent to a subacute rehabilitation facility. His mobility is much worse than when he entered the hospital, and he does not seem to be recovering. What should I do?
A: This type of situation is unfortunately way too common. Hospitalizations can set anyone back in terms of mobility and require rehab to return that person back to their baseline mobility — and this is especially evident for people with PD. The hope is that with rehab now, your husband can slowly return to the way he was before the hospital. It will require a lot of commitment and work from the physical therapy department of the skilled nursing facility that he is in. Your role can be to make sure that the physical therapists at the facility know what he was capable of before the hospitalization. They may assume that since he is not mobile now, he was not mobile before, and they therefore won’t have the right end goals in mind.
Dr. Rebecca Gilbert is the Chief Mission Officer at APDA. She oversees APDA’s research portfolio in conjunction with APDA’s Scientific Advisory Board. She also provides medical and clinical expertise to support APDA programming as well as print and web content.
To learn more from Dr. Gilbert, be sure to check out the Dr. Gilbert Hosts series on our YouTube channel.