“ASK THE DOCTOR” with Dr. Rebecca Gilbert

 

Q.  I have a progressive problem with excessive fluid flowing in my nose, mouth, and throat glands. Can this be related to PD?

A.  Yes, it can. Sialorrhea (too much saliva) is a well-recognized problem in PD. People with PD can have problems controlling saliva because the muscles of the oral cavity, face, and neck may have less control than normal, and there may be a delay in the person’s ability to trigger a swallow. Sometimes, there is excess saliva in the mouth because swallowing is less frequent, due to the general slowness of movement that accompanies PD. The sialorrhea may be mild and result in a simple issue such as a wet pillow in the morning; or in some cases, it can be severe, leading to excessive drooling which may cause embarrassment and social isolation for some.

Rhinorrhea (runny nose) is a lesser known PD problem. It is important to note that the rhinorrhea of PD is not associated with a viral infection or environmental allergies — or any other common cause of runny nose.

There are potential treatments for both of these problems, so do not wait to talk to your doctor about them. Steps can be taken to lessen the impact of your symptoms.

Q.  How do you begin to assemble a team of providers? My mother has medications but no advice on adjusting dosages, no therapies, etc.

A.  There are many different types of providers that can make up a PD healthcare team — from physical and occupational therapists to social workers and neuropsychologists, and more. The most streamlined way to build your mother’s healthcare team is to find a movement disorders specialist who can then refer you to other practitioners as needed. Do not hesitate to be proactive and ask her movement disorder specialist about this and let him/her know you very much want to round out her medical care with other specialists and support.