With Parkinson’s disease it’s hard to discern what’s a disease thing, what’s an old-age thing, what’s a medication thing or is that a thing that’s always been there but now it’s more noticeable because I’m paying closer attention. I am unsure of these categories and unsure whether it is important or even significant to categorize various symptoms and features of this sometimes gone, sometimes debilitating disease.

New mental behaviors – vocal dreams, location confusion, physical dreams (not somnambulism), sense of an extra person or persons in the house, cognitive failure, short term memory impairment, minor mania, circular thinking, anxiety about imminent events, extra drama, heightened emotion, strong nostalgia.

New physical behaviors – inability to easily rise from a sitting to standing position, balance control, shuffled walk, a hard to describe fidgety motion while concentrating on another tv show or other activity, spontaneous loss of consciousness, sudden loss of stamina, chest tightness, mild nausea.

New combinational behaviors – incontinence anxiety, visual acuity and reaction to perceived emergency, thought vocalization, spontaneous tears.

Vocal dreams started early after Cheryl was initially given Sinemet as a treatment for PD. It is and old drug combination that dates from the 1960’s. I do not think she talked in her sleep before this prescription was given to her about 12 years ago. If she did it was not common or memorable. Her brother was somnambulant and she tells stories about him as a child walking about. Doctors seem to place importance on various family traits, so, Cheryl may be genetically predisposed to talking in her sleep. The Sinemet seems to have heightened this effect.

On rarer occasions she will act out the dream in bed. We sleep in a queen size bed and she will poke or push at me if that is what her dream requires. She can not recall her dream even if I awaken her from it.

The reference made to thought vocalizations is interesting to see.

Cheryl started sensing others in the room after we down sized into a 3 bedroom condo. It is a two story building and there are other residents above us that can be heard upon occasion. So, it is my guess that her brain is interpreting these occasional noises as someone else is here. Reasoning with her about it does not remain in her memory even though we have discussed this several times. We previously lived in a big old house with it’s own creaks and groans. She never reported sensing others around.

Cognitive decline is slow. Often she seems to get stuck. Which sends her into a “circular thinking ” mode that can be hard to break out of. A typical example; she has through 49 years or so of marriage been the family accounts manager. Plans a monthly budget, balances the checking account, an absolute hawk on credit card purchases. I have misplaced receipts in the past, never again. She is good at it. I think it is enjoyable to her. Recently she forgot to note an ATM withdrawal in the check register and additionally she noted an ATM deposit twice. The combination of these two errors got her “stuck” and launched her into a circular review of her entries for days (evenings actually) until I got her to tell me what she was in a panic about. I use the term “circular” because she wound find one error and lose it before finding the other. Around and around for several days.

Forgetfulness is a mishmash of things. Not finding the right word. Saying a word that means the opposite. Or simply forgetting what we were talking about 5 minutes ago, so, we have to repeat it. For me, her husband and caregiver, its exasperating. I keep plugging ahead.

Oh, by the way, Parkinson’s disease sucks. Big time!