Time for another Parky Perspective. This one is on a topic near and dear to all Parky’s. Progression. Simply put, progression is the worsening of our disease. Parkinson’s disease is caused by the gradual reduction of dopamine, an important neurotransmitter. The medications I take do a great job of correcting the imbalance caused by my body’s reduced dopamine production. Unfortunately, the medications get less effective as time goes on, necessitating a gradual increase in dosage to maintain the same level of functionality. There’s no set schedule of how the increase in medications will happen over time. Every Parky is unique. Even the types of medications that work best for us vary from individual to individual. I’ve been on the same 3 medications and dosages for about a year. Initially, it was great. My “on” time was usually very good and I didn’t usually have much “off” time. As time has gone on however, I’ve noticed some things. Compared to a year ago, I’m a little stiffer in my right leg and my arm. I no longer wake up mostly “on”. The crushing Parky fatigue I often get in the afternoon is a little more difficult to shake. I’m a tiny bit slower. The familiar pain in my right foot is a bit more persistent.. It’s subtle. There’s even a new symptom, numbness and twitching in my lip. Weird right? I’m still hoping I can chalk up the changes to other recent events, but I’ve been through this before. Hoping, wishing, it would just go away. But it only gets worse.On the bright side, I’m still on relatively low dosages of medication and will hopefully have many years of relatively good functionality before I need to consider more extreme treatments such as Deep Brain Stimulation (DBS). Overall, I’ve got plenty to be thankful for!As always, stay positive my friends! And keep moving (especially you Parky’s)!