June 2009

NVFPC – Northern Virginia Fall Prevention Coalition

We had two speakers today from the Northern Virginia Fall Prevention Coalition. Tony Schaffer from  Schaffer Construction   began by speaking about the coalition which follows Center for Disease Control (CDC) guidelines. There are 21 state coalitions but neither Maryland nor Virginia are among them.  Click here to go to the CDC website.

A study that inspired him to get involved compared 2 counties over a 4 year period – one was monitored and in the other one they talked to   doctors about fall prevention. The results were 1800 fewer injuries in the county where MD’s were educated about fall prevention, resulting in a savings of 21 million dollars.

A lot of the work that is done by Schaffer construction is “band-aid” work as a result of a crisis. Tony explained it is better to plan in advance to avoid injury. He hopes to “plant the seed” to get people thinking about preventing falls and hope that they will pass the message on to their doctors.

Ernest Dixon, pharmacist and owner of  Centreville Medical Arts Pharmacy. He explained that the medical arts involves things like mixing medications into a cream to be applied topically when someone   cannot take them orally.

Ernest talked about the symptoms of Parkinson’s (tremor, stiffness, bradykinesia, postural instability) and cause (lack of dopamine).

3 Components to Medication Management
1. Know yourself / know your body – relay odd things to your doctor or nurse
2. Know your provider
3. Know your pharmacy – build a good relationship with your pharmacist so you can ask questions

There’s a transdermal patch available only in Europe called NeuPro (rotigotine).

There is no “best” medication for Parkinson’s. Because everyone is different the best medication(s) is what works best for the individual.

Amino acids are precursors to dopamine and naturally occurring transmitters in the brain.

3 main neurotransmitters
1. dopamine – lacking in Parkinson’s disease
2. norepinephrine affects blood pressure & pulse
3. seratonin – medications like Prozac & Zoloft increase seratonin

If you skip a dose of carbidopa levodopa don’t double up.

Over-the-counter medications that are contraindicated with   Parkinson’s medications:
Bonine, Meclizine for motion sickness Anticholinergics
Antihistamines
Always check with your pharmacist!

Some sleep medications that might be useful are Ambien, Lunesta and Sonata. A natural alternative is melatonin but it’s not compatible with Azilect.

Prior to surgery, you might have to stop taking certain medications.

For more information on drug interactions check out the National Institute of Health website:
Drug, Supplement & Herbal Information page
Parkinson’s disease page
Health Topics page

Generic vs. brand name medications?
• Sometimes the generic drugs aren’t as effective
• The insurance companies decide which one you’ll get but the patient can demand the brand (possibly at extra cost) instead of the generic
• The active ingredient is the same in brand name medications and generic, but it’s the pill binders that dissolve differently, at different speeds. They can also affect the ability to divide a pill.

Tony Schaffer then spoke about modifications to the home.

Some useful things to consider:
night lights – in the bathroom, bedroom, hallway
handrails – on both sides of the stairs
lighting – use a double bulb feature so one bulb is always there
outside lighting
motion sensors – can be outside and inside
bathrooms – handrail, grab bars in the shower/tub
non-slip flooring in shower/tub – secured with double sided tape
bed rails – some swing out of the way, possibly need to be attached, don’t   buy the cheapest, expect to pay about $200
doorways – use offset hinges to increase width and outswing doors for easier access if someone should fall and the room is small

Check out support products at Health Craft.

Have your therapist and contractor work together so that assistive devices like grab bars and handrails are placed in the correct place and at the   correct height.

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