A Field Guide to Hillary’s Parkinson’s Disease

This guide is designed to allow the television viewer to identify Parkinson’s Disease manifestations in Hillary Clinton’s public appearances. It should be noted that the signs you or I can see can be reduced dramatically by medications and physical tactics. Breakthrough signs can sometimes by suppressed by injected apomorphine (Apokyn pen). The signs are grouped by the ones most likely to be seen in public.

PD is classically characterized by tremors at rest. This means that these repetitive movements usually show up when the sufferer is not actively using the affected body part.

1. Tremors.
   1. “Pill rolling” tremor. This is a repetitive hand movement that looks like one is rolling a pill between the thumb and forefinger. It can be suppressed by using the hand to motion or by pressing it against an object such as a microphone, lectern, the sufferers other arm or chest.
   2. “Head nodding” tremor. When another person is speaking, the sufferer’s head may nod repetitively.
2. Freezes
   1. Sudden stoppage of normal activity when the brain basically shuts down briefly. It can happen in the middle of a sentence. An odd posture may be held for several seconds or longer.
   2. If a freeze comes while walking, the sufferer will probably fall woodenly with no protective motions of the arms.
3. Slow movement (bradykinesia)
   1. Shorter than normal steps
   2. Dragging feet
   3. Difficulty getting up out of chairs or climbing steps. This may lead to the use of handrails in a manner that allows the arms to supply climbing strength.
4. Parkinson’s Disease Levodopa Induced Dyskinesia (PD-LID) – May be triggered by flashes or loud sounds, or may come randomly without warning.
   1. Bizarre body motions
5. PD Postures
   1. “Bug eyes”
   2. Abnormally wide smile
   3. Abnormally open mouth
   4. Uncomfortable or unnatural hand positions
6. Signs of swallowing disorder
   1. Persistent cough
7. Rigidity
   1. Loss of fluidity in general body motions
   2. “Wooden” facial expressions
8. Impaired balance
   1. Difficulty walking or standing, manifested by “gripping” lecterns, handrails, or physically supporting persons.
9. Loss of automatic movements
   1. Reduced blinking. This will create a “staring” sort of look.
   2. Loss of arm swing while walking
   3. Persistence of smile beyond socially acceptable limits.
10. Speech changes
    1. Words may not be as clear
    2. Speech may hesitate
    3. Speech may be somewhat monotone

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