While prostate exams are not something most men look forward to, they are essential to ensuring long-term health. Early detection is key when it comes to most conditions, including prostate cancer. Knowing when to begin screening tests, what they involve, and how your risk factors affect the timeline for getting screened can help reduce your anxiety and encourage proactive decision-making.

In this article, we’ll be discussing all of that and more.

Key Takeaways

• Most men should begin prostate cancer screening at 50 years old, but some may need to start earlier.
• A digital rectal exam (DRE) and prostate-specific antigen (PSA) blood test are the most commonly used screening tests.
• Black men and men with a family history of prostate cancer are at a higher risk and should get screened around 40–45 years old.

What Age Do You Get a Prostate Exam?

Most men should have their first prostate exam around 50 years old, but this recommendation changes depending on the following risk factors.

• Being Black
• Having an immediate family member who was diagnosed with prostate cancer when they were 65 years old or younger.
• Having multiple family members diagnosed with prostate cancer before age 65.

If you have any of the mentioned risk factors, the age for screening goes down to 40–45 years old. These recommendations come from leading medical organizations like the American Cancer Society, and urology experts nationwide concur. Having a thorough conversation with your doctor about when screening is right for you can lead to life-saving action.

What Can You Expect During a Prostate Exam?

The two main types of prostate screening are the digital rectal exam (DRE) and the prostate-specific antigen (PSA) blood test. It’s important to note that these tests are screening tools, meaning they help discover whether further testing is necessary. They are not used to make a diagnosis.

Digital Rectal Exam (DRE)

During a DRE, your physician will gently insert a finger that is gloved and lubricated into the rectum to feel for any abnormalities in the prostate gland. While it can be uncomfortable, the test itself typically does not hurt and only lasts up to a couple of minutes. You can also request a chaperone to be present.

Prostate-Specific Antigen (PSA) Test

A PSA test measures the amount of PSA in your blood. Prostate-specific antigen is a protein that your prostate produces, and raised levels can be a sign of prostate cancer. However, it also becomes elevated from other non-cancerous conditions like prostatitis or an enlarged prostate. All that’s needed for this test is to have your blood drawn.

If either test leads to concerning results, your provider may recommend you for additional testing, such as a prostate biopsy or imaging studies. As diagnostic tools, these tests can only be used to alert you and your doctor to any potential issues.

The Racial Disparity In Prostate Cancer Risk & Outcomes

As we mentioned earlier, being Black is one of the few risk factors for prostate cancer. That’s because Black men are 1.7x more likely to be diagnosed with prostate cancer and 2.1x more likely to die from it compared to white men. Although research to understand the exact reason for these disparities is ongoing, experts believe it to be a combination of genetic, socioeconomic, and healthcare access factors at play.

Black men are also more likely to be diagnosed at later stages. The farther along a cancer progresses, the more aggressive and more challenging to treat it becomes, which leads to more severe outcomes. That’s why screening earlier is especially important for Black men and men with a strong family history.

How Often Should You Be Screened?

How often you should get screened after your first exam depends on your results. If you have normal DRE/PSA results, you may not need another test for two years. For the PSA screening, under 2.5 ng/mL is considered normal, with levels 2.5 ng/mL or higher considered abnormal. If you have borderline results, your doctor may recommend having another screening in six months to monitor your condition more closely. For elevated or abnormal findings, your doctor will want to further investigate with additional tests in the form of imaging or a biopsy.

Even though prostate cancer progresses slowly, consistent follow-up is just as necessary as the initial exam.

RMC Offers Support at Every Stage of Men’s Health

If you’ve ever wondered at what age you get a prostate exam, you’re not the first. Don’t delay having a conversation with your doctor and getting screened when the time is right. At RMC, our team of experienced providers is here to protect your health and help give you peace of mind. If you’re unsure about your timeline, contact RMC to schedule an appointment with a provider.

June is Men’s Health Month! At RMC, we’re dedicating this time to raising awareness about the unique health challenges that affect men and encouraging proactive steps toward healthier habits and better well-being. While some conditions affect men and women alike, some diseases and health risks are more likely to develop in men because of differences in biological, behavioral, and social factors. 

At RMC, we believe that awareness is the first step toward prevention and early detection, so let’s explore some male-specific or male-predominant health issues and why understanding them could help save lives.

Key Takeaways

• June is Men’s Health Month.
• Some health challenges are more common in men than women, and vice versa. 
• Men experience higher rates of melanoma, gout, kidney stones, and heart disease than women.
• Prostate cancer is a leading cancer in men; however, testicular cancer is more likely to occur in younger men.

Why Do Men Face Unique Health Challenges?

Although men and women often face similar health issues, the way these conditions manifest can vary significantly between genders. This difference in how conditions appear also affects how early they’re diagnosed, which can affect treatment and the survival rate if the condition is life-threatening. Additionally, hormonal makeup, risk-taking behavior, and even a reluctance to seek medical attention can influence how health issues develop in men over time.

It’s important to spotlight these disparities and encourage preventive care during Men’s Health Month, so let’s get started.

The Leading Male Cancer: Prostate Cancer

As a disease that affects the male reproductive system, prostate cancer is one of the more obvious male-specific health conditions and is one of the most common cancers among men in the U.S.

Prostate cancer begins and develops in the prostate gland, which is located below a male’s bladder and in front of their rectum. This gland is a vital part of the male reproductive system as it helps keep sperm healthy by creating a fluid that combines with semen. In most cases, prostate cancer develops slowly, with early stages having no symptoms whatsoever. However, once symptoms do start to appear, this can be a sign that the cancer has progressed to a more advanced stage. Prostate cancer symptoms can include trouble urinating or blood in one’s urine. 

Routine screenings such as prostate-specific antigen (PSA) tests are one way to help catch prostate cancer early, especially in men over 50 years old or those who have a family history of the cancer.

The Young Man’s Disease: Testicular Cancer

Less common than prostate cancer, testicular cancer tends to affect younger men, typically between 15 and 35 years old, more often than older men. It can grow fast; however, early detection and treatment are highly effective in most cases. Men can stay proactive about prevention by regularly performing self-exams, looking for any unusual lumps, swelling, or discomfort in their testicles. Don’t hesitate to talk to your doctor immediately if anything seems suspicious or irregular.

Testicular cancer is a reminder that youth isn’t always a promise of healthiness and that everyone should stay alert about their health, regardless of age.

The Silent Killer: Heart Disease

Heart disease is the leading cause of death for men in the United States, with conditions like high blood pressure, cholesterol, and poor lifestyle habits increasing men’s risk. Statistics show that men are more likely than women to develop cardiovascular health problems at a younger age. Smoking and poor eating choices are two driving contributors, and symptoms can include chest pain, shortness of breath, and fatigue. But sometimes there are no symptoms until a major event like a heart attack occurs. 

The silent nature of heart disease makes routine screenings and heart-healthy habits all the more critical.

Skin Cancer with a Gender Gap: Melanoma

This may surprise you, but melanoma, the most serious form of skin cancer, affects men at higher rates than women, especially after the age of 50. Why is that, you might ask? Research suggests it could be due to both behavioral factors and biological differences in male and female skin. Men are less likely to take care of their skin by using sunscreen and are more likely to have outdoor jobs where they experience more frequent sun exposure.

Men usually develop melanoma on their backs and other hard-to-see areas, making regular skin checks and annual dermatologist visits very important. The good news is that when detected early, melanoma is highly treatable.

Painful but Preventable: Gout and Kidney Stones

Gout is another condition that disproportionately affects men, striking suddenly and painfully in the big toe, ankles, or knees. As a form of inflammatory arthritis, gout is caused by high levels of uric acid, a waste product your body naturally produces. Studies show that estrogen naturally helps eliminate uric acid from the body, which would explain the higher number of instances in men. 

Similarly, kidney stones are more common in men than in women and cause intense pain, nausea, and blood in the urine. Dehydration and high-protein, salty diets, which men are more likely to consume, all contribute to the formation of kidney stones. Staying hydrated and eating a balanced, healthy diet are the easiest ways to avoid this excruciating condition.

Aggressive & Overlooked: Pancreatic Cancer

Although pancreatic cancer can affect both genders, men have a slightly elevated risk compared to women. Even as one of the most aggressive cancers, pancreatic cancer is, unfortunately, often diagnosed late due to its vague and early symptoms, which include abdominal pain, weight loss, and fatigue. 

Smoking, being overweight, and having a family history of pancreatic cancer can all increase a man’s risk.

Prioritize Your Health with RMC This Men’s Health Month

During Men’s Health Month, we want to urge men to take charge of their health by scheduling checkups, asking questions, and staying informed about conditions that disproportionately affect them. Awareness can truly be life-saving!
If you or a loved one hasn’t had a recent health screening, now is the time! Contact us at RMC to schedule a wellness exam or speak with one of our specialists.

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative condition that progressively affects the nerve cells in a person’s brain and spinal cord; it is also sometimes referred to as Lou Gehrig’s disease. With a relatively quick progression that generally only gives patients 3–5 years to live after diagnosis, ALS has a devastating emotional impact on those diagnosed as well as their family, friends, and caregivers. As ALS Awareness Month, May is a special time of the year to shine a light on this disease and encourage education, advocacy, and support for those affected. 

In this blog, we’re exploring the seven stages of ALS to help our readers understand how the disease typically progresses and what can be expected along the way.

Key Takeaways

• May is ALS Awareness Month and a time to educate the public and support those affected.
• ALS progresses in seven distinct stages from early symptoms and diagnosis to the need for palliative care.
• Understanding the stages of ALS can help patients and caregivers prepare and seek the appropriate care. 
• RMC specialists can help people navigate neurological diagnoses with compassion and expertise.

What ALS Is and Why It Matters

ALS occurs when motor neurons, the nerve cells responsible for voluntary movement, begin to die. When the brain’s motor neurons die, it can lead to various symptoms, but for ALS in particular, it causes muscle weakness, loss of coordination, and eventually full-body paralysis. Unfortunately, there’s no cure at this time; however, early intervention and supportive care can improve a patient’s quality of life.

ALS Awareness Month is essential in spreading information about the early symptoms, treatment options, and the emotional toll this disease can take. It also helps drive research funding and foster community support.

Understanding how ALS progresses is a critical part of preparing for how it will affect a patient and their loved ones emotionally, physically, and medically. 

Stage 1: Early Symptoms and Mild Weakness

In the earliest stage, ALS often presents itself as something deceptively small. This could be feeling weakness in one hand, slight tripping when you walk, or occasional muscle cramps. Because they’re not necessarily reserved for the elderly or sick, these symptoms can be easily dismissed. Early ALS symptoms can happen to anyone occasionally, which is why diagnosis can be delayed. However, catching ALS at this stage can help patients and families begin planning, exploring therapies, and accessing support systems early on.

Stage 2: Muscle Imbalance and Worsening Symptoms

As ALS progresses into the second stage, symptoms become more noticeable. As the muscles atrophy and experience an increasing loss of stimulation from nerve cells, muscle weakness and stiffness become more widespread throughout the patient’s body and begin to affect both sides of the body. Simple tasks you used to be able to do with ease, such as buttoning your shirt, opening a door with a key, or going up the stairs, may all of a sudden become difficult to do.

Although it may seem early, physical therapy, assistive devices, and occupational therapy often become a part of daily life. But by incorporating these changes early on, most patients can maintain independence for longer.

Stage 3: Loss of Motor Control

By the third stage, many patients begin to experience extensive muscle weakness and a loss of fine motor control, such as being unable to grasp or hold objects. Additionally, walking without a cane, walker, or other assistive device may no longer be possible. Breathing becomes increasingly labored during any physical activity, and fatigue causes a decrease in energy levels.

Communication assistance may also become necessary at this stage, as slurred speech and slowed pronunciation set in.

Step 4: Severe Weakness and Limited Mobility

At the fourth stage, most muscles are significantly weakened, and patients may require a wheelchair full-time as well as help with daily activities. Bulbar symptoms also begin to worsen with increased difficulty swallowing as muscles in the mouth and throat deteriorate.

At this point, nutritional support, speech therapy, and respiratory assessments become critical care components for the patient.

Step 5: Complete Dependency and Respiratory Concerns

Stage five is marked by complete dependency on caregivers for daily living activities like dressing, bathing, and eating because they can’t use their arms and hands anymore. Around this time, a feeding tube may become necessary to ensure the patient receives enough food and nutrients. 

Breathing issues also become more pronounced, and many patients begin using non-invasive ventilation devices, such as BiPAP, to help them breathe. The patient’s decline in respiratory function can also lead to secondary symptoms, including headaches, worsening fatigue, brain fog, and increased susceptibility to pneumonia.

At this time, emotional support and compassionate caregiving are vital for the emotional and mental well-being of the patient and their loved ones.

Step 6: Loss of Voluntary Movement

At the sixth stage, voluntary muscle movement is almost entirely gone. Assistive technology, such as eye-tracking devices or speech-generating apps, is especially helpful for communication at this stage. Although patients may not be able to move, they can still be mentally alert and aware and want to interact with family, friends, and caregivers.

Hospice care or specialized neurological care is typically introduced around this time to ensure the patient remains as comfortable as possible and maintains a dignified presence.

Stage 7: End-Stage ALS

In its final stage, ALS affects the muscles responsible for breathing. At this stage, patients can choose to use mechanical ventilation or may transition to palliative care. What can be most difficult is that while the patient’s body continues to deteriorate, it’s not uncommon for their mind to remain intact. This underscores the emotional weight of the disease and the importance of social support and activities with family members to decrease levels of depression.

Each ALS journey is unique, and while this stage is the most physically limiting, it’s also when the human spirit and resilience can shine the brightest.

How RMC Supports Patients During ALS Awareness Month and Beyond

If you or someone you love has recently received an ALS diagnosis, you are not alone. At RMC, our compassionate neurologists and support staff are here to help you (and your family) navigate the journey ahead with courage and endurance. From diagnosis through every stage of progression, we’re committed to personalized care, advanced treatment options, and emotional support.
Let RMC be your trusted partner in care this ALS Awareness Month. Contact us today for a consultation or to learn more about the resources available to you.

Every May, Lyme Disease Awareness Month brings attention to the United States’ most common vector-borne disease (a disease spread by blood-feeding bugs like mosquitoes, ticks, and fleas). This year, we’re educating our readers on the possibility and effect of maternal-fetal transmission and what expecting mothers or women trying to get pregnant need to know about the most common disease that comes from a tick bite. Keep reading to learn more!

Key Takeaways

•  Lyme disease is a vector-borne infectious disease spread through tick bites.
•  The CDC recognizes congenital Lyme disease.
•  Early diagnosis and treatment are crucial to ensuring the safety and health of expectant mothers and their babies.

What Is Lyme Disease?

While maternal-fetal transmission of Lyme disease is considered rare, over the last few decades, more research has emerged showing it does occur, especially if the mother does not receive treatment.

Proving that Lyme disease, caused by the Borrelia burgdorferi bacterium and spread by tick bites, can be passed from the mother to the baby during pregnancy has been a challenge for multiple reasons. The top among them is that Lyme disease is difficult to diagnose in adults, let alone the unborn. As a disease with many common symptoms that are also symptoms of other common illnesses and diseases, Lyme disease is often misdiagnosed and underdiagnosed.

The first stage of symptoms of Lyme disease includes headache, fatigue, flu-like symptoms, joint pain, and a rash that can appear in different shapes (not just the well-known bullseye rash). If the disease is not quickly diagnosed and treated, it can lead to long-term effects such as facial paralysis, neurological problems, cognitive impairment, hearing and vision problems, inflammation of the heart and brain, and more.

It’s also worth noting that testing for Lyme disease can be somewhat unreliable, as test accuracy depends on how long you’ve been infected. This is because it’s an antibody test looking for signs that your immune system has been trying to fight off the infection, which can take a while (around 4–6 weeks). Additionally, it’s not easy to determine if a patient has been cured after completing their antibiotic treatment, as their blood will likely continue to test positive for Lyme bacteria antibodies for months or years after the bacteria are gone.

Can Lyme Disease Cross the Placenta?

In 2020, the CDC acknowledged that Lyme disease can infect the mother’s placenta during pregnancy and, in rare cases, the baby. This is known as congenital Lyme or referred to as maternal-fetal transmission or vertical transmission. The possibility of transmission increases if the mother doesn’t receive treatment with antibiotics.

However, the Lyme disease community has long suspected this to be the case. A 2018 review published in PLOS One examined 45 studies and found that while it’s rare due to limited research, there is evidence of maternal-fetal transmission of Lyme disease bacteria. It goes on to suggest that adverse outcomes were more likely in cases where the disease was left untreated during the pregnancy. The review goes on to suggest that serious complications, including miscarriage or congenital abnormalities, were more likely when the mother didn’t receive immediate treatment.

In other instances, doctors such as Rosalie Greenberg, M.D., Child and Adolescent Psychiatrist, have documented their experience diagnosing congenital Lyme in children of mothers with Lyme disease. She notes how, without more research for doctors to draw upon, more children will suffer as Lyme disease is underdiagnosed or misdiagnosed in children of mothers who have or had Lyme disease.

Research Revelations and Shortcomings

As we mentioned earlier, one of the challenges in studying congenital Lyme disease is that it is difficult to prove, as the symptoms in infants often mimic those of many other common conditions. These symptoms can range from developmental delays to neurological or cardiac abnormalities. Still, some physicians and researchers like Dr. Greenberg have been able to document cases that strongly suggest vertical transmission happens more often than is reported.

Sue Faber, R.N., provides a literature review spanning 32 years, offering a comprehensive overview of repeated patterns across case studies. These include adverse pregnancy outcomes, the presence of spirochetes in fetal tissue, and infants born with Lyme-consistent symptoms, some of whom even test positive themselves.

Although the CDC states that there’s no evidence of Lyme being passed through breastfeeding, the research on this aspect of transmission still appears to be inconclusive.

More research is still needed to fully understand the scope and mechanics of congenital Lyme. Still, the existing evidence is enough to warrant caution and proactive care by expectant mothers and their OB-GYNs.

Why Early Diagnosis Matters During Lyme Disease Awareness Month

The good news is that timely antibiotic treatment is highly effective for mothers and babies. The CDC emphasizes that when Lyme disease is diagnosed early on in pregnant women, it is safe to treat with antibiotics like oral amoxicillin or cefuroxime; however, doxycycline can have adverse effects on fetuses and should be avoided during pregnancy. Early treatment dramatically decreases the risk of unborn babies contracting the disease and usually results in a full, quick recovery for mom.

RMC Supports Expecting Mothers Year-Round

As we recognize Lyme Disease Awareness Month, we want to ensure that all of our readers understand that RMC is here to take all of their health concerns seriously, especially those of women who are expecting. This joyful time also comes with concerns that can be overwhelming. If a tick has bitten you or you are experiencing multiple worrisome symptoms, our maternal medical care team is ready to ensure you and your baby are safe.

If you’re pregnant and think you may have been exposed to a tick, don’t wait. Contact RMC today to talk with a provider about your symptoms and get the care that you need!

Caring for a loved one with Parkinson’s disease comes with emotional, physical, and logistical challenges. As we’ve discussed in this month’s two previous blogs, this neurodegenerative disorder affects movement, balance, and even mood and memory. As a patient’s symptoms evolve, having a detailed and flexible Parkinson’s disease (PD) care plan becomes essential, not just to support the person who has Parkinson’s, but to help their caregiver stay grounded, organized, and prepared.

Key Takeaways

• Parkinson’s disease is a progressive condition that has motor and non-motor symptoms.
• A care plan should evolve with your loved one’s or the patient’s needs.
• Safety, daily routines, emotional support, and long-term planning are critical components.
• Caregiver self-care and outside support are just as important as patient care.

Parkinson’s disease typically progresses in stages, which we discussed in our last article, and you can read in full here. Early symptoms might include tremors, stiffness, and slight balance issues. Over time, these symptoms can become more intense and expand to include non-motor or movement-related symptoms such as speech, cognitive function, and emotional well-being. This unpredictability makes a well-structured care plan vital.

While medications like levodopa can help manage a patient’s symptoms, they don’t stop the disease’s progression, which is why your care plan should be proactive. Incorporating strategies for both current symptoms and anticipating future needs can help make an already challenging situation more bearable. 

Building the Foundation of a Parkinson’s Disease Care Plan

Start by focusing on daily routines. Structure can provide a sense of control and comfort for your loved one. Set consistent times for medication, meals, exercise, and rest. Physical therapy, occupational therapy, and even speech therapy may become key components of the daily schedule. 

Next, consider their safety. Making home modifications to reduce fall risks, such as installing grab bars in bathrooms, ensuring walkways are clear, and acquiring mobility aids (like a walker or wheelchair), will make life easier on you and your patient. PD can affect balance and coordination, so preventing them from getting hurt in a fall is crucial.

Additionally, cognitive and emotional support are just as important. Depression and anxiety are common among people with PD. Regular check-ins with a mental health professional, support group, and family can help keep your loved one’s spirits up and emotions regulated.

Now, let’s discuss some adjustments you can make to daily habits as their PD progresses.

Dressing with Dignity and Ease

Getting dressed can become frustrating as fine motor skills decline. Adaptive clothing like velcro shoes, front-fastening bras, and elastic waistbands can help your loved one stay independent longer. Help them choose soft, easy-to-layer clothing and lay out items in the order they’ll be worn to make mornings go smoother.

Most people with PD want to maintain their independence as long as possible. But when they do begin to request assistance, approach it with patience and positivity. As their safety allows, let them maintain as much autonomy as possible, even if it means taking some extra time.

Activities and Daily Movement

Staying active is one of the best ways to maintain mobility, balance, and even mood. Gentle exercises, such as walking, stretching, tai chi, and chair yoga, can help improve flexibility and reduce stiffness. Include these in your care plan several times a week, and coordinate with a physical therapist to tailor activities to your patient’s ability. 

You can also incorporate cognitive activities like putting together puzzles, reading out loud, music therapy, or reminiscing over old photos. These activities help support memory and emotional well-being while also helping you connect with each other.

Hygiene and Bathroom Assistance

Hygiene routines may gradually require more hands-on help. As we said earlier, home modifications can make things much easier. Install grab bars and non-slip mats in the shower, and consider getting a shower chair for safety. Electric toothbrushes and razor handles with good grip can also help promote more grooming independence.

Eventually, incontinence may become part of your patient’s journey. You’ll want to be proactive about this part of your care plan. Don’t wait for an accident to happen before you begin to keep leak-proof underwear and other supplies on hand. Include regular bathroom breaks in their schedule, keep supplies discreetly available, and consult with their doctor about management options when necessary.

Encouraging Restful Sleep

Many PD patients begin to experience disruptions in their sleep due to tremors, stiffness, or side effects of their medication. You can help promote better rest by sticking to a consistent bedtime routine and creating a calming sleep environment with dim lighting, minimal noise, and a supportive mattress.

Keep nighttime paths well-lit to prevent falls if your loved one needs to get up in the middle of the night. If their sleep issues continue or get worse, speak with their neurologist or healthcare provider. Sometimes, small adjustments to medication can make a big difference.

Keeping Up with Medical Appointments

Regular checkups with neurologists, physical therapists, speech-language pathologists, and primary care physicians are vital to managing PD effectively. Keep a detailed calendar with upcoming appointments and maintain a binder or digital file that includes a list of their medications, notes on symptoms, and test results. This is a simple way to keep track of all pertinent medical history and have it easily accessible when you need it.

If you observe new symptoms, either physical or mental, don’t hesitate to bring them up with their doctor. It’s important for them to be as informed as possible about your loved one’s progression.

Don’t Forget to Plan Ahead

Long-term planning might feel overwhelming, but it’s one of the most loving things you can do. Legal documents like a living will, healthcare proxy, and power of attorney should be discussed and established early, while your loved one can still be fully present in the decisions.

You should also talk openly about financial planning and future care needs, such as in-home care or assisted living. Scheduling regular family meetings to reassess the plan and make adjustments as the disease progresses can help make the process easier on everyone.

Create a Parkinson’s Disease Care Plan with the Help of RMC

At RMC, we understand how overwhelming caregiving can be, especially when trying to balance caring for a loved one with the logistics of daily care. Our neurological team at RMC offers compassionate, expert support to help you build a Parkinson’s disease care plan tailored to your loved one’s specific needs. From daily routines to long-term planning, we’ll walk with you every step of the way. Contact us today to take the first step toward more confident caregiving!

As Parkinson’s Awareness Month continues, we’re publishing this series of articles to provide essential information that people should know about the disease. In our last article, we discussed how Parkinson’s disease (PD) is the second-leading neurodegenerative disorder in the United States, early indicators, and how dopamine deficiency causes its physical symptoms. 

In today’s article, we’re talking about the 5 stages of Parkinson’s disease. While no two journeys with PD are exactly alike, understanding the disease’s progression can help patients and families prepare for the road ahead. Keep reading to learn more.

Key Takeaways

• Patients in stages 1–3 of Parkinson’s disease are still able to live on their own, but daily tasks are more difficult and take longer.
• Independence is the main factor that separates stages three and four.
• There are different rating scales to measure the progression of Parkinson’s disease in addition to the Hoehn and Yahr Scale

Researchers Margaret Hoehn and Melvin Yahr developed a framework to measure the progression of Parkinson’s disease (PD) in the 1960s, and doctors still use it today. However, it is not the only rating scale that is used to diagnose how severe a patient’s disorder is. (In fact, there are at least eight other scales/tests/questionnaires that can be used to determine where a patient is in their journey with PD.)

Here’s a breakdown of what those stages typically look like and how RMC’s neurology team is here to help at every step.

Stage 1: Mild, Often-Missed Symptoms

This early stage is subtle. Tremors or shaking might affect just one side of the body. Close family members may notice slight changes in posture, facial expressions, or walking patterns, but a person’s daily activities aren’t impacted yet. At this stage, symptoms are easy to overlook or misattribute simply to aging or fatigue.

Stage 2: Noticeable Changes Begin

At stage two, symptoms become more obvious and begin to affect both sides of the body. Muscle stiffness, slower movements, known as bradykinesia, and increased tremors can start to interfere with tasks. They may also begin to experience speech difficulties. Though a patient’s balance remains intact, everyday activities will start to take longer, and they will need to start seeking medical support.

There’s no way to predict individual progression as every PD case is unique. For some people, it only takes months to progress from stage one to stage two. For others, it can take years. During this time, patients remain independent

Stage 3: Mid-Stage Parkinson’s and Balance Issues

Stage three is considered mid-stage PD, at which point falling becomes a concern as balance issues begin to manifest. Reflexes also start slowing down, as well as overall movement. Patients can remain independent at this stage, but daily tasks will take them much longer. Some home adjustments may be necessary, or the patient may need to use assistive devices. Stage 3 can sometimes be aided by medication and physical or occupational therapy.

Stage 4: Significant Assistance Required

At stage four, a patient’s mobility becomes seriously compromised, and many need to employ the use of a walker to move around. They also need help with daily living activities like getting dressed, eating, and bathing. Living alone can be unsafe due to the increased risk of falling. Physical decline usually progresses faster than mental decline. So while a person may no longer be able to live alone, their cognition may still be relatively unaffected.

Stage 5: Advanced Parkinson’s

Stage five is the most severe stage of Parkinson’s disease. Patients are often unable to stand or walk due to the advanced stiffness in their legs, leaving them bedridden or confined to a wheelchair. Around-the-clock care is almost always necessary. Additionally, hallucinations, delusions, and dementia may develop.

Understanding the 5 Stages of Parkinson’s Disease with RMC

Knowing the 5 stages of Parkinson’s disease can empower patients and their families to prepare for what’s ahead and seek the right care at the right time. At RMC, our compassionate neurology team provides expert diagnosis, treatment, and support through every phase of PD. Whether you’re just beginning to notice symptoms in yourself or a loved one or are navigating later-stage challenges as a caretaker, we’re here to help. Contact RMC today to find the support you need.

As the second-leading neurodegenerative disorder in the U.S., it is estimated that approximately 1 million Americans have Parkinson’s disease (PD). However, that number is likely much higher, given that no two people have the exact same symptoms, making it commonly misdiagnosed. 

April is Parkinson’s Awareness Month, so we’re using this month’s articles to spread understanding and support those diagnosed, their families, and their caregivers. In this first article, we’re sharing five key things everyone should know about PD. Let’s get started!

Key Takeaways

• Parkinson’s disease symptoms are caused by a breakdown in dopamine production in the brain’s substantia nigra.
• Exercise is one of the best ways to manage motor skill decline.
• Deep Brain Stimulation (DBS) is a promising treatment option for improving some individuals’ quality of life.

1. Dopamine Deficiency Disrupts Movement

As we mentioned, Parkinson’s disease (PD) is a neurodegenerative disorder, meaning it stems from the brain. What actually causes the physical, and later on mental, decline is the reduction in dopamine production in the neurons, the brain’s communication network, located in the substantia nigra, the area of the brain that controls motor function. As a neurotransmitter, dopamine travels between neurons, sending messages in the brain that are then translated to other parts of the body to create movement that is smooth and intentional.

As neurons malfunction and die in the substantia nigra, less dopamine is produced, resulting in physical, and later mental, declines in muscle control. This decline leads to chronic, progressive effects on the central nervous system, creating the hallmark motor symptoms of PD, such as tremors, stiffness, and slowness of movement.

2. Exercise Is a Lifeline for Parkinson’s Patients

Because PD attacks mobility, flexibility, and balance, a disciplined exercise regime is one of the most effective methods to manage the disorder. As soon as a patient is diagnosed, if they are not already regularly active, they should be prescribed a daily exercise program that aligns with their physical fitness capabilities by a physical therapist. Exercises with a strong focus on aerobic activity, flexibility and stretching, resistance training, as well as yoga, pilates, tai chi, dance, and non-contact boxing are all appropriate, effective activities. One study even showed that patients who participated in tai chi had reduced balance impairment and fewer falls.

Additionally, these activities also help curb non-movement symptoms like anxiety, depression, and constipation.

3. It’s Not Just Shaking—Non-Motor Parkinson’s Symptoms

While PD is commonly known to affect a person’s motor skills, as the disorder progresses, it begins to affect non-motor systems. Non-motor symptoms can actually be the most challenging to manage for both the patient and their caregiver and family. Common examples include:

• Insomnia
• Mood swings
• Anxiety
• Depression
• Dementia
• Delayed cognitive function
• Hallucinations and delusions
• Constipation
• Bladder issues
• Freezing of gait (a condition where every step you take feels like you’re falling)

4. Deep Brain Stimulation for Symptom Relief

One of the most promising options for treating advanced PD is Deep Brain Stimulation (DBS). It involves electrodes placed deeply in the brain and what’s called a pulse generator implanted under the patient’s collarbone. The pulse generator sends controlled electrical signals to the electrodes through wires under the skin. When activated, the two mechanisms stimulate the brain, blocking signals that cause a lot of the symptoms people experience with PD.

This treatment option is usually turned to once PD has become more advanced and a patient has developed a resistance to or is experiencing side effects from long-term levodopa (a motor symptom treatment medication) use.

Although it’s not a cure and there is much that is still unknown about some aspects of DBS, it has shown potential to significantly improve the quality of life for some individuals.

5. Early Clues You Might Miss

Two symptoms that often appear before classic motor symptoms are micrographia and anosmia. Micrographia is characterized by abnormally small, crowded handwriting that may also progressively get smaller. Anosmia refers to a partial or complete loss of smell that can be temporary or permanent. If you notice either of these changes in yourself or a loved one, you can mention it to your physician or them or their physician if you’re their caretaker and stay vigilant to any other more obvious symptoms of PD. 

RMC Supports Parkinson’s Awareness Month

Raising awareness is one of the best ways to increase early diagnosis for Parkinson’s Disease. With April being Parkinson’s Awareness Month, we here at RMC are doing our part to ensure our community stays informed on what to look for and what actions to take. 
With a full spectrum of care for brain, spinal cord, and nervous system conditions and a neurologic care team that includes neurologists, neurovascular surgeons, and other healthcare professionals, we’re here to provide comprehensive care for those experiencing a decline or change in their brain health. Contact us today for access to advanced diagnostic technology and progressive treatment options for neurological conditions.

Every health decision holds a little more weight when you’re pregnant. Understandably so, since you’re making decisions for you and your baby. One question that can cause some serious anxiety is, “Can you get a colonoscopy while pregnant?” If you’re experiencing severe gastrointestinal symptoms or your doctor suspects a more serious issue, it’s essential to understand the benefits, risks, and alternatives of colonoscopies for pregnant women.

Keep reading to learn what they are.

Key Takeaways

•  Colonoscopies are a last resort to diagnose gastrointestinal problems in pregnant women.
•  If a colonoscopy must be performed, the second trimester is the safest time to do so. 
•  Potential risks involve preterm labor, fetal hypoxia, and miscarriage.

While you can technically get a colonoscopy while pregnant, it’s not the first (or second) option your doctor would recommend. They are generally reserved for cases where the benefits of having a colonoscopy outweigh the risks. It’s definitely not a procedure that a gastroenterologist would recommend lightly. This is mainly because of concerns about anesthesia exposure and the potential risks to both you and your baby. However, if your symptoms suggest a potentially serious condition, like inflammatory bowel disease (IBD), colorectal cancer, or severe gastrointestinal bleeding, your OB-GYN, along with your gastroenterologist, may agree to move forward with the procedure.

Timing Matters: When Is It Safest?

Studies show that when done extremely carefully, colonoscopies during pregnancy are relatively safe when performed in the second trimester. According to a 2014 study published in the World Journal of Gastroenterology, there’s no strong evidence linking colonoscopies to pregnancy complications when doctors take the appropriate precautions. However, the timing of the procedure is crucial. Waiting until the second trimester (between 13 and 26 weeks) is highly recommended. This is when the risk of miscarriage is lower and the uterus is still relatively small, all of which allows for safer sedation and less pressure to be put on the abdomen.

What Are the Risks?

Like any medical procedure during pregnancy, colonoscopies are not risk-free, which is why doctors are so hesitant to perform them. The biggest concerns include potential preterm labor, fetal hypoxia (a lack of oxygen to the baby), or even miscarriage, although this outcome is pretty rare. Practicing careful sedation and monitoring the baby before and after the procedure helps significantly reduce these risks, however. Having an experienced gastroenterologist work closely with your OB-GYN to ensure every possible precaution is taken is key to ensuring a successful outcome for you and your baby.

Special Considerations: What Adjustments Are Made?

Obviously, there are many differences in performing a colonoscopy on a pregnant patient as opposed to someone who’s not pregnant. As such, risk factors are taken into account, and special considerations and adjustments are made to ensure the procedure is as safe as possible and protect mom and baby:

• Sedation: Medications like propofol are generally avoided. Doctors will opt, instead, for lighter sedation or even conscious sedation to minimize the baby’s exposure to medication.
• Positioning: The patient is carefully positioned, typically on their left side, to prevent compression of the inferior vena cava. This is a large vein that can affect blood flow to the uterus if pressed on.
• Shorter Procedures: Colonoscopies usually last about an hour, not including recovery time. But with a pregnant patient, gastroenterologists would aim to make the procedure as quick and efficient as possible to reduce any potential stress on the pregnancy.

Guidelines for Endoscopy in Pregnant Women

Because of the serious risks involved, the American Society for Gastrointestinal Endoscopy created the following guidelines for endoscopists to follow when performing a colonoscopy on women who are pregnant:

1. Always have a strong reason to perform the procedure, especially in high-risk pregnancies.
2. Whenever possible, only perform the endoscopy during the second trimester.
3. Use the lowest effective dose of sedation medication.
4. Drugs used should be restricted to category B whenever possible.
5. Reduce the procedure timeline to as short as possible.
6. Avoid vena cava or aortic compression by positioning the patient in the left pelvic tilt or left lateral position.
7. Check the baby’s heartbeat before sedation and after the procedure is complete.
8. Obstetric support should be available whenever pregnancy-related complications occur. Keep obstetric support on standby in case pregnancy-related complications occur.
9. Obstetric complications of endoscopy include placental abruption, imminent delivery, ruptured membranes, and eclampsia are defined.

What Are the Alternatives?

While colonoscopies continue to remain the gold standard when doctors need a clear, definitive look inside the colon, in some cases, like pregnancy, non-invasive alternatives may be considered first. For example, MRI enterography, CT colonography, and abdominal ultrasounds are three imaging studies that can sometimes provide enough information without requiring sedation or being as invasive as a colonoscopy. 

Other alternatives include stool tests and bloodwork to detect blood in the stool and other information that could be enough to guide treatment decisions during pregnancy. It’s all about balancing the urgency of your GI symptoms with the safest diagnostic methods.

Trust RMC for Compassionate GI Care During Pregnancy

Like many aspects of a pregnancy journey, facing a colonoscopy while pregnant can feel overwhelming. However, you can rest assured that our experienced team of gastroenterologists and maternity medical care team will take every precaution to keep you and your baby safe. If you’re experiencing severe gastrointestinal symptoms or something just doesn’t feel right during your pregnancy, don’t wait—early evaluation can make a real difference in your health and peace of mind.

Contact RMC today to schedule an appointment or learn more about your options so you can receive the expert, compassionate care you and your baby deserve.

As we discussed in last week’s article, colorectal cancer rates have been increasing in individuals younger than 50 years old since the 1990s. If you’re considered high risk for colorectal cancer or are 45 years or older, your doctor has probably recommended you get screened. Screening is the best method for finding precancerous polyps (growths in the lining of the colon) and for early detection of colorectal cancer.

Since colonoscopies are generally considered the gold standard for screening and detection, you may be wondering, “Who performs a colonoscopy?” Read on to learn the answer to your question and more details about the colonoscopy procedure and preparation.

Key Takeaways

• Gastroenterologists perform colonoscopies and specialize in the digestive system.
• During a colonoscopy, a colonoscope is used to view the inner lining of your colon.
• Colonoscopy preparation includes adjusting your diet to ensure your colon is empty on the day of the procedure.

Who Performs a Colonoscopy?

If it’s time for you to receive your first colon cancer screening, you may be wondering, “Who performs a colonoscopy?” Unless you’ve had gastrointestinal issues in the past, this likely isn’t something you’ve given much thought to. But the fact of the matter is, as you get older, you’ll most likely come into contact with more doctors who specialize in different fields of medicine, like gastroenterologists. Which brings us to the answer to our question, “Who performs a colonoscopy?”

A gastroenterologist is a doctor who specializes in the human digestive system. This includes organs such as your stomach, pancreas, gallbladder, liver, small and large intestine, rectum, and anus. Performing colonoscopies is one of the ways a gastroenterologist screens their patients for cancer and other digestive problems.

However, gastroenterologists aren’t the only doctors who perform this procedure. It can also be performed by an endoscopist, a person trained to operate an endoscope, or a colorectal surgeon, a doctor specializing in gastrointestinal disease.

What Is a Colonoscopy?

A colonoscopy allows your gastroenterologist to see any growths, tears, and other issues that could be affecting your colon, making it one of the best ways to diagnose colorectal cancer.

By using a colonoscope, a lighted camera attached to a catheter, inserted into the anus, your gastroenterologist is able to view video footage of the inner lining of your colon to look for any abnormalities.

The colonoscope blows carbon dioxide to inflate the colon and helps your doctor get a better view. The colonoscope goes to the end of the large intestine, with your doctor examining the lining all along the way and then examining it again as the colonoscope is removed. If your gastroenterologist sees any polyps, which is not uncommon, they can remove them during the colonoscopy.

How Do You Prepare for a Colonoscopy?

Once your doctor has scheduled your colonoscopy, they’ll also give you instructions on how to adjust your diet the week leading up to your procedure. This usually includes a low-fiber diet a few days before and then a clear liquid diet the day before your appointment. This means no solid foods the day before the procedure.

The evening before your colonoscopy, you’ll take a laxative to help remove any remaining stool from your large intestine. This is to ensure that your colon is as free and clear as possible to give your doctor the best view of it. Failure to follow your doctor’s instructions may result in having to reschedule your colonoscopy and redo the prior week’s preparation.

What Can You Expect During and After the Procedure?

Since a colonoscopy requires general anesthesia or a mild sedative, you’ll need to bring someone who can drive you back home on the day of your appointment. It generally takes about a day for anesthesia to wear off. You can speak with your doctor about the best sedation option for you.

With sedation, you shouldn’t feel any pain, even if your surgeon has to biopsy or remove polyps, but you may be aware of mild discomfort or gas pain as the colonoscope inflates your colon with carbon dioxide.

The whole experience usually takes around two hours, with the second hour used for recovery and waking up from the anesthesia.

When to See an RMC Gastroenterologist

The idea of getting a colonoscopy is enough to make one feel more than uncomfortable. However, our expert team of gastroenterologists here at RMC are fully equipped to handle your procedure with care, compassion, and comfort. If your doctor has recommended you receive a colonoscopy to screen for colorectal cancer or another reason, ask them about a referral to RMC’s Digestive Care Services. Our gastroenterology physicians are ready to deliver the expertise and care you require.