• Fri. Aug 5th, 2022

Parkinson’s disease expert delivers insightful training session to Newnan Support Group

ByJulie J. Helfer

May 11, 2021

By Gary May

Dr Gathline Etienne, Neurologist at Piedmont Physicians, Newnan, recently visited Newnan Parkinson’s Support Group to talk about a treatment option as the disease progresses and the standard pill regimen no longer works effectively.

She began her presentation with a brief review of the pathology of Parkinson’s disease and traditional treatment.

According to Dr. Etienne, Parkinson’s disease is caused by a loss of dopamine, a neurotransmitter in the brain. Dopamine allows the transmission of nerve messages from the brain to the muscles and is crucial for voluntary movement.

The disease is progressive and idiosyncratic, affecting each person in different ways with a variety of motor and non-motor symptoms that progressively worsen over time. Classic motor or movement-related symptoms of the disease include tremors, rigidity, slow movements, poor balance, and difficulty walking.

People with PD are often also affected by a variety of non-motor symptoms such as loss of smell, soft voice, sleep behavior disturbances and constipation. The root cause of PD is unknown and there is no known cure.

Yet, with proper medication, regular exercise, a healthy lifestyle, and a caring support team, most Parkinson’s patients live productive and fulfilling lives for many years.

The traditional medication for PD is carbidopa-levodopa, usually taken in pill form. When levodopa is in pill form, it travels through the stomach into the small intestine where it is absorbed into the bloodstream, travels to the brain, and is converted into dopamine, an active neurotransmitter.

“The problem is that as the disease progresses, higher doses of carbidopa-levodopa are needed and need to be taken more often,” Dr. Etienne said. “While the goal of therapy is to keep levodopa levels at the ‘sweet spot’ where the drug is on time and working well throughout the day and evening, sometimes stomach issues affect For example, a pill can get stuck in the stomach or a high-protein meal can bind to levodopa and affect absorption in the small intestine, resulting in an “off” period where symptoms manifest unexpectedly due to low levels of dopamine.On the other hand, levodopa levels can become too high, leading to dyskinesia (involuntary dance movements).

One solution to treat these motor fluctuations in advanced PD is to deliver carbidopa-levodopa in liquid form directly into the small intestine so that it can be absorbed quickly. The prescription drug and process, developed by AbbVie Pharmaceutical, is called Duopa. Treatment involves placing a drug delivery port in the stomach wall and connecting a portable pump to deliver levodopa continuously for 16 hours.

Dr. Etienne reviewed the mechanics of the Duopa process and discussed the pros and cons, including safety information and potential side effects. A patient joined the meeting via Zoom to share her personal journey and positive experience with Duopa. “Benefits include less ‘time out’ from continuous levodopa administration, no more setting alarms to take pills every few hours, and the freedom to travel and live a more active lifestyle,” noted Dr Etienne.

Dr. Etienne concluded her presentation with an extensive question and answer session, answering not only questions about Duopa but also other medical questions regarding Parkinson’s disease.

After the meeting, during social time, group members expressed their appreciation for Dr. Etienne’s educational presentation and his personal and energetic presentation. For example, group member Eva Busha said, “I have lived with Parkinson’s disease for almost 20 years and the disease has progressed dramatically in the last two years. I am nearing the advanced stage of the disease and unfortunately my medications are not as effective in controlling my tremors for the entire time between doses. It’s so good to know that there are now treatment options that can help improve my quality of life. It gives me hope.”

Interestingly, Dr. Etienne also has a connection to and support for the PD Advocate Program, a unique service founded by Larry Bergeson and affiliated with the Newnan Support Group. The program originated from discussions between Dr. Etienne and Larry, who is a patient of Dr. Etienne, about the special needs of people newly diagnosed with Parkinson’s disease.

The PD Advocate program provides trained advocates – volunteers who have experienced the effects of the disease – to support and assist new patients with Parkinson’s disease in a number of ways, such as pointing out helpful information and resources, as well as ‘providing encouragement and emotional support.

“Our job now,” Bergeson said, “is to spread the word to let the community know that we provide this valuable service.” The program includes a three-pronged brochure that the advocacy team is working to distribute to neurologists’ offices and other appropriate locations in the area.

People recently diagnosed with Parkinson’s disease or their partners in care can log into the PD Advocate program by emailing their details to [email protected]

The Newnan Parkinson’s Support Group meets the second Tuesday of each month at Newnan First United Methodist Church at 2:30 p.m. A typical program includes time for fellowship and mutual support, as well as a guest speaker with expertise in one or more dimensions of Parkinson’s disease. For more information, visit the group’s website at www.newnanpd.org.