“ASK THE DOCTOR” with Dr. Rebecca Gilbert

Q. I was diagnosed with PD a few months ago by my primary care physician, and I have my first appointment with a movement disorder specialist this week. Can you suggest ways to prepare for this visit?

A. I would do three things to help make your visit the most productive and informative:

• Bring along a “scribe” — a family member or friend who will take notes. Then you can review the notes afterward at your own pace.
• Make a list of questions that you have and bring them along. Toward the beginning of the visit, mention to the doctor that you have this list, and you would like a few minutes at the end to discuss the things that have been on your mind.
• Before the visit, make a list of any symptoms you have and how often you have them. It can be hard to remember everything at the appointment, especially if you’re a little nervous. You can download the free APDA Symptom Tracker app to help you keep track of your symptoms.

Q. I have had PD for about 10 years, and recently, I have been experiencing frequent falls. Why is this happening?

A. Falls can be dangerous, and it’s important to try to minimize them. There could be a number of reasons why you are experiencing frequent falls. Here are a few:

• Loss of postural reflexes, or the loss of the ability to right oneself when thrown off balance, is a very common part of PD.
• Drops in blood pressure is a common non-motor symptom of PD that can cause dizziness as well as passing out.
• Decreased visuospatial skills, which interferes with your ability to navigate your way around obstacles, can contribute to falls.
• Freezing of gait is an abnormal pattern of walking associated with PD in which there are sudden, short, and temporary episodes of an inability to move the feet forward despite the intention to walk. This can cause falls.
• Dyskinesias, or extra unwanted movements, can be a side effect of PD medication and can be throwing you off balance. All in all, you need to discuss your falls with your neurologist who can investigate exactly what is causing your falls and try to correct it either with adjustments in medication, physical therapy, or an assistive device.

To send in a PD question of your own, use the Ask A Doctor portal on our website!

Dr. Rebecca Gilbert is the Chief Scientific 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.