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DIAGNOSING DAD

22-12-2008

Christmas is a family time and this one is a bit more special for Stirrer blogger and neurologist Dr David Nicholl.

Life sometimes throws up the strangest quirks. I have spent over 10 years performing research into the genetics of Parkinson’s disease, so it was more than a little strange when I suspected my father might have the condition.

Bluntly, how as his son could I sort this one out on a family holiday?

We spent a few days together in May by the seaside in Northern Ireland - the weather was perfect, but things were clearly amiss with my father. Dad is 82 years old, but he had dramatically slowed up, he had an impassive expression, his gait was hesitant and he walked with a reduced arm swing - all features of this, the second commonest neurodegenerative disorder.

However he had no rest tremor - a classic sign of Parkinson’s - but my concern was a pragmatic one. His memory had deteriorated significantly- normally he was always as obsessed about news and current events as I am - yet, to my horror he was still driving.

En route to our holiday, we had witnessed the aftermath of a fatal road accident, yet my Mum had told me he was avoiding any right hand turns and she wasn’t allowed to speak when he was driving. I was worried that he might have the commonest neurodegenerative disorder, Alzheimers, instead.

Something was going to have to be done, but first somebody had to make a diagnosis, but how? I was on holiday and had no kit with me. Necessity being the mother of invention, an objet d’art, a handy wooden flamingo in the holiday home was used as a makeshift tendon hammer.

He clearly had signs of Parkinsonism but also profound cognitive problems as well - this retired anaesthetist could not recall 3 simple objects after a couple of minutes. I managed to get his GP on the case – it’s wise to be son first, doctor second and get someone else to make the decisions.

So I e-mailed a neurological colleague in Belfast to get him sorted. His memory problems cleared (much to the relief of all of us) with alteration of some of his medication and he has now improved significantly with medication for his underlying Parkinson’s.

So at least this Christmas, Dad will be able to have some chance of trying to catch up with his grandchildren thanks, amongst other things, to that wooden flamingo.

There seems a degree of payback, when as a child, my Dad probably saved my life, aged 5 when I’d knocked myself unconscious by breaking a gas-pipe in the bedroom. Maybe every home needs its own anaesthetic team and ventilator to resuscitate unconscious offspring.

Glad I could return the favour.

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