Focus on Parkinson's disease

What is Parkinson's disease?

Parkinson's disease is a long-lasting and progressive disorder that affects movement. This means that the symptoms of the disease not only persist but also tend to intensify over time. The condition is characterized by the malfunction and eventual death of essential nerve cells in the brain, known as neurons. Specifically, Parkinson's primarily targets neurons located in a part of the brain referred to as the substantia nigra. Some of these neurons are responsible for producing dopamine, a crucial chemical that transmits signals to the brain areas that govern movement and coordination. As the disease advances, the production of dopamine diminishes significantly, which leads to difficulties in controlling movements effectively.

Symptoms are grouped in these categories

The array of symptoms experienced by individuals with Parkinson's disease can differ widely from one person to another. The primary motor symptoms associated with Parkinson's include:

• Tremor: This is often one of the earliest signs of the condition and typically manifests as a shaking or tremor in the hands, arms, legs, jaw, or face. In many cases, the tremor starts in a limb, particularly in the hand or fingers, and may present as a characteristic back-and-forth motion of the thumb and forefinger, commonly referred to as a pill-rolling tremor. A distinctive feature of Parkinson's disease is the presence of a tremor in the hand when it is at rest.
• Slowness of movement (bradykinesia): As the disease progresses, individuals may experience a noticeable reduction in their ability to move, leading to a significant slowdown of movements. This can make even simple tasks feel challenging and time-consuming. For instance, a person may find that their steps become shorter while walking or that they struggle to rise from a seated position. Additionally, some individuals may notice that they drag their feet as they attempt to walk, which further complicates mobility.
• Muscle rigidity: Stiffness in the muscles can occur in any area of the body and can severely limit the range of motion. This rigidity can also lead to discomfort and pain, making daily activities more difficult.
• Impaired posture and balance: Many individuals with Parkinson's may develop a stooped posture, and they might also experience difficulties with balance, which can increase the risk of falls.
• Loss of automatic movements: There may be a noticeable decline in the ability to perform unconscious movements, such as blinking, smiling, or swinging the arms while walking. This can lead to a more rigid appearance and reduced expressiveness.
• Changes in speech: Individuals may encounter speech-related issues, which can manifest as speaking softly, quickly, or with slurring. There may also be hesitations before speaking, and the tone of voice may become more monotone, lacking the usual variations in inflection.
• Alterations in writing: Writing may become increasingly difficult, and the size of the handwriting might appear smaller than usual, a condition known as micrographia.

The signs and symptoms of Parkinson's disease

The symptoms and signs associated with Parkinson's disease can vary significantly from one individual to another. In the early stages, these signs may be quite mild and can easily go unnoticed. Symptoms often begin on one side of the body and tend to remain more pronounced on that side, even as the disease progresses and begins to affect both sides of the body.

Possible causes of Parkinson's disease.

While the exact cause of Parkinson's disease remains elusive, several factors seem to contribute to its development. These include:

• Your genes: Researchers have identified specific genetic mutations that can lead to Parkinson's disease, though these mutations are relatively rare and typically occur in families with a strong history of the disease. Certain genetic variations may increase the risk of developing Parkinson's disease, but the risk associated with each of these genetic markers is generally small.
• Environmental triggers: Exposure to specific toxins or environmental factors has been linked to a heightened risk of developing Parkinson's disease, although the overall risk remains relatively low. Studies have shown that various changes occur in the brains of individuals with Parkinson's, although the reasons for these changes are not yet fully understood. One notable change includes the presence of Lewy bodies—microscopic clumps of specific substances found within brain cells that serve as markers for Parkinson's disease. Researchers believe that these Lewy bodies may hold significant clues regarding the origins of the disease. One of the primary substances found in Lewy bodies is a protein called alpha-synuclein (A-synuclein), which appears in a clumped form that brain cells cannot break down. This area of research is currently a focal point for many scientists studying Parkinson's disease.

How to register on the chronic programme

If you have received a diagnosis of Addison’s disease, it is essential to have your doctor reach out to our Chronic Medicine Department at 0860 11 78 59 to initiate your registration on the Chronic Medicine Management Programme. A chronic medicine consultant will work closely with your healthcare provider to coordinate your treatment plan. Once the necessary diagnostic criteria are satisfied and relevant blood test results are received, your treatment will be authorized. We will inform you whether your treatment is covered under the Momentum Medical Scheme formulary or if you will need to make a co-payment. After receiving authorization, you can present your prescription to your designated service provider to obtain your medication, and the claim will be processed accordingly. A designated service provider (DSP) is a healthcare professional, such as a doctor, pharmacist, or hospital, that is preferred by the medical scheme for the diagnosis, treatment, or care of a Prescribed Minimum Benefit condition. If you opt not to use the DSP and choose a different healthcare provider, a co-payment may apply. Typically, the authorization lasts for a period of 12 months. If there are no changes to the medication you require, your doctor or pharmacist can contact us at 0860 11 78 59 to renew the authorization. The same procedure applies in cases where there are any changes or additions to your treatment plan.

For additional information regarding your chronic benefits and where to obtain chronic medication and treatment, please click here.

Hospitalization

If you find yourself needing hospitalization due to complications related to cardiac failure, you can easily log into the Momentum App, reach out to us through the web chat feature available on momentummedicalscheme.co.za, send us an email at [e-mail], or contact us via WhatsApp or by calling 0860 11 78 59 to request pre-authorization for your hospital stay. Upon your request, we will assign a case manager to monitor your hospitalization and provide necessary follow-up.

Treatment plan

Once you are successfully registered in the program, you will gain access to a comprehensive treatment plan. This plan may cover various essential services, including medical tests, doctor visits, and other benefits that your healthcare provider deems medically necessary. Our clinical team will review these services to ensure they are appropriate for your condition.

Compliance

Please ensure your claims include the appropriate ICD-10 code

It is imperative that all claims submitted include the correct ICD-10 codes (diagnostic codes) to facilitate accurate identification and processing of the claims under the Chronic Benefit. If claims are submitted without the relevant ICD-10 codes, if you exceed the frequency limits on consultations or tests, or if the treatment is deemed not clinically appropriate, we may process the claims using your Day-to-day Benefits instead.

Contact us

If you have any questions or need assistance, feel free to reach out to us via the web chat feature at momentummedicalscheme.co.za, email us at [e-mail], send a WhatsApp message, or call us at 0860 11 78 59.

Glossary of terms

Designated service providers refer to the network of healthcare professionals, including associated general practitioners and specialists, as well as state facilities, that Momentum Medical Scheme utilizes to diagnose and treat members for Prescribed Minimum Benefits.

A formulary is a comprehensive list of medications covered under your specific plan, from which your doctor can prescribe the appropriate treatment for your chronic condition.

ICD-10 refers to the International Classification of Diseases, 10th Revision, which is the coding system used for diagnosis.

Prescribed Minimum Benefits represent a set of essential benefits that all medical schemes in South Africa are mandated to cover, according to the Medical Schemes Act 131 of 1998 and its accompanying regulations. To access these benefits, certain conditions must be met: your medical condition must qualify for coverage and be included in the defined list of Prescribed Minimum Benefit conditions; the treatment required must align with the specified treatments in the defined benefits; and you must utilize the Scheme’s Designated Service Providers. For further clarification on Designated Service Providers, please refer to the definition provided on page 2.

If you choose to use non-designated service providers voluntarily, the Scheme will cover benefits only up to the Momentum Medical Scheme Rate, and relevant co-payments will apply. However, if you utilize non-designated service providers in cases of emergency medical conditions, this is regarded as involuntary, and co-payments will be waived.