Secondary Symptoms

My bladder issues with PD are a real drag !   Some people do not know that your brain "controls" your bladder.  Cells in the portion of the brain associated with urine control produce a chemical called Dopamine .  Its release helps to keep the bladder in the off  condition (bladder is relaxed while filling with urine), and prevents the bladder from contracting - when the bladder becomes full, the brain is alerted and then signals the bladder to contract (turn on ) to release urine.  In PD, these cells are lost or reduced in number resulting in bladder on and off problems.  My biggest issues so far have been overactive bladder and not being able to urinate at all. Overactive bladder for me means sudden urgency but not sure how full my bladder is until I get to the john (feels very full but may not be.)  Not being able to urinate at all is serious - I have plenty of disposable intermittent catheters and lube whenever that suddenly happens...Loads of fun ...

I spent Labor Day weekend in NYC visiting friends from Chicago.  I had mentioned to them in an earlier email that I was pretty good during the day, but not so good at night.  Sort of a "sundowning" effect.   I actually did much better than I expected - even J. mentioned it - so I felt good about that.  I still dread friends seeing me in an "off-state", especially as my face tends to stiffen up, making it difficult to talk. But I continued on, popping extra doses of carbidopa/levodopa before going out to the movies, or a late dinner, or an evening walk.  I was so happy to be with A & H,  that it lessened my symptoms.  Laughter and stimulating conversation can do wonders.