Ask Dr. Friedman- Frequently Asked Questions answered by one of our Favorite Movement Disorders Docs — Parkinson Secrets – Treatment Tips for PWP’s & Caregivers –

Dr. Friedman attended medical school at Columbia University, College of Physicians and Surgeons, and neurology residency at the Neurological Institute of NY. He has been practicing in Rhode Island since 1982, and is the Director of The Movement Disorders Program at Butler Hospital, and Professor in the Department of Neurology of the Warren Alpert Medical School of Brown University. His clinical research has focused on behavioral aspects of Parkinson’s disease and he is an amazing advocate for persons with Parkinson’s. We were lucky to interview Dr. Friedman for this blog.

His newest book is free:

He also wrote Making the Connection Between Brain and Behavior: Coping with Parkinson’s Disease, which discusses only behavioral topics. This book is not free and is available on Amazon, or possibly in your community library. 

There are 5 stages in the Hoehn-Yahr staging system for PD. These were described in a 1967 paper about the response to the then new drug, L-Dopa. This staging system, in which stage 1 means PD on one side only; stage 2 means PD on both sides but with normal balance; stage 3 means that walking is independent but balance is impaired; stage 4 means that walking is poor and often requires a cane or walker; and stage 5 is for those unable to walk. The problem is that patients don’t progress in a predictable fashion from one stage to the next, and, problems that don’t involve walking or balance aren’t taken into account. A stage 3 patient with normal speech and cognition may be in much better shape than a person who is stage 1 with speech problems. A stage one patient whose dominant side is affected may be disabled but if the problem had been on the other side at the same level of severity, the person may only be inconvenienced.

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