What Do I Do With My Old Icd-10 Code Books Something Else For Parkies to Worry About

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Something Else For Parkies to Worry About

According to a letter to the editor in the June 2010 issue of “Parkinsonism & Related Disorders,” there is new concern for those who bear the burden of this disease.

Oh, we already know about our vulnerability to ICD (impulse control disorders). The main list includes pathological gambling (not guilty!), compulsive shopping (from time to time; does that make it a compulsive?), hypersexuality (I wish!), and compulsive eating (Okay, you get it).

Now there is a new one. According to the letter to the editor, two. count ’em — two cases of kleptomania induced by dopamine replacement therapy have been reported. (See, we parkers don’t make our own dopamine anymore and have to replace it with pills or we’ll be sitting very, very still for the rest of our lives.)

The letter describes one of two shocking cases of “Parkies Gone Bad!”

She was a 68-year-old woman with a 14-year history of PD that began with tremors in her right arm.

A few months earlier, she had noticed that she was suffering from depression (a common disorder in PD) and it was interfering with her quality of life. But what better way to cheer yourself up than shopping? When even that didn’t work because she started to feel guilty when she noticed that her shopping sprees were becoming compulsive and she felt like she had to hide it from her family, she started splurging…usually cosmetics and beauty products, which she didn’t. he doesn’t need it and would sell it later. (“Here, Mabel. I snagged these at Target. You can have them.”)

This evolved into a supermarket sweep of illegally obtained food, where they stole stuff from supermarkets and were excited about the theft… until they got caught. Then he regretted it.

But he stole things until his neurologist stopped the dopamine replacement therapy. He didn’t handle it well at all, so a variety of other drugs were used to quell his penchant for stealing stuff.

The letter writer suggests that this is probably more widespread than it appears, as most kleptos don’t give up and are likely to steal as many shiny trinkets as their trembling hands can get their hands on.

Considering the significant personal distress and legal consequences, the delay in diagnosis due to shame, and the fact that people with kleptomania do not present themselves, screening for kleptomania in PD patients with shame seems relevant. Development of ICDs.”

I think it’s fine. Putting newly diagnosed patients on a lie detector test six months after starting dopamine agonist therapy may do the trick. Because you KNOW you won’t get an honest answer if you ask your patient, “Is he better? Is the tremor better? Are you stealing something”? So, how do you tell if your patient is a klepto, doc? Leave a shiny trinket on the desk and leave the room for a few minutes, then come back and see if the coin is still there? Because if you need honest answers from someone who gets excitement from lifting jeweled snuff boxes in their otherwise depressing life, then this kleptomania will go undiagnosed for a long time!

In the interest of full disclosure, I once swiped a candy bar from a grocery store and ate it on the way home. But I was 10, 35 years before I was diagnosed with PD. So I’m sure PD had nothing to do with it.

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