Description
Parkinson's disease is a chronic and progressive movement disorder, meaning that symptoms continue and worsen over time. Parkinson’s involves the malfunction and death of vital nerve cells in the brain, called neurons. Parkinson's primarily affects neurons in an area of the brain called the substantia nigra. Some of these dying neurons produce dopamine, a chemical that sends messages to the part of the brain that controls movement and coordination. As Parkinson’s progresses, the amount of dopamine produced in the brain decreases, leaving a person unable to control movement normally.
The specific group of symptoms that an individual experiences varies from person to person. Primary motor signs of Parkinson’s disease include the following:
- tremor of the hands, arms, legs, jaw and face
- slowness of movement, called bradykinesia
- rigidity or stiffness of the limbs and trunk
- postural instability or impaired balance and coordination
The signs and symptoms of Parkinson's disease
Parkinson's disease symptoms and signs may vary from person to person. Early signs may be mild and go unnoticed. Symptoms often begin on one side of your body and usually remain worse on that side, even after symptoms begin to affect both sides.
Parkinson's signs and symptoms may include:
- Tremor - a tremor, or shaking, usually begins in a limb, often your hand or fingers. You may notice a back-and-forth rubbing of your thumb and forefinger, known as a pill-rolling tremor. One characteristic of Parkinson's disease is a tremor of your hand when it is relaxed (at rest).
- Slowed movement (bradykinesia) - over time, Parkinson's disease may reduce your ability to move and slow your movement, making simple tasks difficult and time-consuming. Your steps may become shorter when you walk, or you may find it difficult to get out of a chair. Also, you may drag your feet as you try to walk, making it difficult to move.
- Rigid muscles - muscle stiffness may occur in any part of your body. The stiff muscles can limit your range of motion and cause you pain.
- Impaired posture and balance - your posture may become stooped, or you may have balance problems.
- Loss of automatic movements - you may have a decreased ability to perform unconscious movements, including blinking, smiling or swinging your arms when you walk.
- Speech changes - you may have speech problems. You may speak softly, quickly, slur or hesitate before talking. Your speech may be more of a monotone rather than with the usual inflections.
- Writing changes - it may become hard to write, and your writing may appear small.
Possible causes of Parkinson's disease
The cause of Parkinson's disease is unknown, but several factors appear to play a role, including:
- Your genes. Researchers have identified specific genetic mutations that can cause Parkinson's disease, but these are uncommon except in rare cases with many family members affected by Parkinson's disease. However, certain gene variations appear to increase the risk of Parkinson's disease but with a relatively small risk of Parkinson's disease for each of these genetic markers.
- Environmental triggers. Exposure to certain toxins or environmental factors may increase the risk of Parkinson’s disease, but the risk is relatively small.
- Researchers have also noted that many changes occur in the brains of people with Parkinson’s disease, although it is not clear why these changes occur. These changes include the presence of Lewy bodies.
- Clumps of specific substances within brain cells are microscopic markers of Parkinson's disease. These are called Lewy bodies, and researchers believe these Lewy bodies hold an important clue to the cause of Parkinson's disease.
- Although many substances are found within Lewy bodies, scientists believe an important one is the natural and widespread protein called alpha-synuclein (A-synuclein). It is found in all Lewy bodies in a clumped form that cells cannot break down.
- This is currently an important focus among Parkinson's disease researchers.
How to register on the chronic programme
Once you have been diagnosed, please ask your doctor to contact our Chronic Medicine Department on 0860 11 78 59 to register you on the Chronic Medicine Management Programme.
The chronic medicine consultant will liaise with your doctor regarding your treatment. Once the diagnostic criteria have been met and x-rays (if applicable) and blood results have been submitted, the treatment will be approved. We will let you know whether the treatment falls within the Momentum Medical Scheme formulary or if you will need to pay a co-payment.
Once you receive authorisation, you can take your prescription to your designated service provider to get your medication and the claim can be submitted. A designated service provider (DSP) is a healthcare provider (doctor, pharmacist, hospital, etc) that is a medical scheme’s first choice when its members require diagnosis, treatment or care for a Prescribed Minimum Benefit condition. If you voluntarily choose not to use the DSP and choose to rather use a different hospital, doctor or pharmacy, we may charge a co-payment.
The authorisation usually expires after 12 months. If there is no change in the medicine you need to take, your doctor or pharmacist can contact us on 0860 11 78 59 to renew the authorisation. The same process applies when there are any changes or additions to your authorisation.
For more on your chronic benefits and where to obtain chronic medicine and treatment, click here.
Hospitalisation
If you need to be hospitalised for complications related to your illness, log in to the Momentum App, contact us via the web chat facility on momentummedicalscheme.co.za, email us at [email protected], send us a WhatsApp message or call us on 0860 11 78 59 to request pre-authorisation. We will allocate a case manager to follow up regarding your hospital stay.
Treatment plan
Once you are registered on the programme, you will have access to a treatment plan, which may include cover for tests, doctors’ visits or other benefits considered medically necessary by your doctor – these will be reviewed by our clinical team to ensure appropriateness.
Compliance
You need to:
- obtain your chronic medication on a monthly basis,
- make sure that you take your medication according to the dosage and quantity prescribed by your doctor, and
- make sure that you do not miss a dose - this is not only important for compliance, but it can have serious implications for your health and wellbeing.
Please make sure your claims have the appropriate ICD-10 code
It is important for all claims to include the appropriate ICD-10 codes (diagnostic codes), so we can identify the claim correctly and pay it from the Chronic Benefit.
We may pay claims from your Day-to-day Benefit if:
- The claims are submitted without the relevant ICD-10 codes.
- You have exceeded the frequency limit on consultations or tests.
- The treatment is not clinically appropriate.
Contact us
You can contact us via the web chat facility on momentummedicalscheme.co.za, email us at [email protected], send us a WhatsApp message or call us on 0860 11 78 59.
Glossary of terms
Designated service providers: Momentum Medical Scheme uses a network of designated service providers, such as Associated GPs and Specialists, as well as State facilities, depending on the circumstances, to diagnose and treat our members for the Prescribed Minimum Benefits.
A formulary is a list of medicines covered on your option, from which a doctor can prescribe the appropriate medication for your chronic condition.
ICD-10 is the diagnosis code.
Prescribed Minimum Benefits is a list of benefits for which all medical schemes in South Africa have to provide cover in terms of the Medical Schemes Act No 131 of 1998. The Prescribed Minimum Benefits include life-threatening emergency medical conditions, a defined set of 271 diagnoses and 26 chronic conditions. Benefits are covered in full if you use the Scheme’s Designated Service Providers (DSPs). If you voluntarily choose to use non-designated service providers, the Scheme will pay benefits up to the Momentum Medical Scheme Rate and relevant co-payments will apply. If you use non-designated service providers in a life-threatening emergency, it is deemed involuntary and co-payments are therefore waived.