Q: A friend of mine recently retired from teaching. She used to be on her feet all day, but now she's slowed down and gained weight. The other day I noticed that her hands and shoulders were shaking as she was working in the kitchen. Could she be developing Parkinson's? — Katie M., Muncie
A: If someone shows signs of Parkinson's disease — trouble with balance, tremors or shaking in lips, hand, arms and/or legs — it's important that he or she see a specialist and get a diagnosis ASAP. Here's why:
•Reason No. 1: It could be something else. Sometimes medications, either by themselves or in combination, can produce symptoms similar to Parkinson's, which develops when your brain stops producing enough dopamine. If that's the problem, adjustments to medications may be necessary or even urgent.
And there's a condition called normal pressure hydrocephalus that can mimic Parkinson's, a stroke or Alzheimer's. It's reversible with surgical intervention.
•Reason No. 2: Early diagnosis of Parkinson's gives you the best chance of finding effective treatment (using medications and short bouts of intense physical activity/therapy) that slows progression and improves day-to-day living. Michael J. Fox was diagnosed at 31; he's now 52.
During the past 19 years, he's started his own foundation ( www.michaeljfox.org) to raise awareness of Parkinson's, and done more writing (three books) and acting (a new series) than most artists do in a lifetime. He's living proof of the importance of early diagnosis and aggressive treatment.
More than 60,000 North Americans are diagnosed with Parkinson's disease annually, and your friend may (or may not) be one of them. But whatever she has, her best hope for the best outcome is to get evaluated by a qualified professional pronto.
Early diagnosis can be difficult, but research indicates that using a transcranial sonogram can ID neural changes and pinpoint the cause of tremors more precisely. We hope you're good enough friends to talk about this openly. Good luck to your friend and you.
Q: I'm 46, and I stopped getting an annual mammogram when the U.S. Preventive Services Task Force issued new recommendations a few years ago. Now I hear a new study suggests that was bad advice and it's younger women who should be screened more aggressively. What's the real deal? — Sonia P., Portland, Ore.
A: Bottom line: You and your doctor should decide what's right for you, but if you are at increased risk because of a family history of breast cancer, certain genetic markers, dense breasts or breast implants, then you should not wait until you're 50 to start getting mammograms every two years (that's the current USPSTF recommendation for women at normal or low risk).
For women with no known risk factors, it's important to realize that when younger women get traditional digital mammograms, they can be misdiagnosed with false positives and put through unnecessary procedures.
Also, younger women develop fast-growing and aggressive breast cancer that often doesn't get caught by conventional screening. Mammograms are much more reliable for spotting slower-growing cancers, which are more common in women over 50.
We understand the impulse to try anything to protect yourself from breast cancer, but for younger women, earlier and more frequent mammograms may not be the answer. Daily physical activity, maintaining a healthy weight and reducing stress are great preventive tools!
What we do know is that whatever age you are when you get a mammogram you want to go to a mammography center that has the latest technology — from 2012 or better.
And there are two ways to make mammograms more accurate and reliable: Contrast-enhanced mammography improves reading accuracy 80 percent; and combining a mammogram with an automated whole-breast ultrasound doubles cancer detection rates.
So talk to your doc, keep an ear out for info about this continuing debate and check this column for our regular updates as more news about this important issue breaks.