Hi Brian,
I was diagnosed 2 years ago with the early stages of PD. I just was put on a medication to help with my balance and gait. For me, there doesn't seem to have much change but all of us are different. I pray for you that your {D [pgresses very slowly.

The PMD Alliance has a on discussion tomorrow you may be interested in. You an register at:

https://www.pmdalliance.org

for

August 8th, 2023
Parkinson’s Fundamentals: Exercise as Medicine

Are you newly diagnosed with Parkinson's disease (PD)? If so, this program is for you. Join us to learn why exercise is the best investment for your current and future health and why you should start now.

We all progress differently and start on the journey in different points. All I can do is reference my own experience. I was diagnosed with a mild tremor in the right hand in Feb 2007. I have seen a gradual progression of deteriorations over the years, but have been able to maintain mobility and flexibility since. I can not run 9 miles, or play soccer any longer, but I have to exercise at least 4 times a week to maintain my flexibility and mobility. Skipping a week leaves me knowing I have slacked off and I have to work to make up. The only thing that has been accepted to delay the progression of PD is exercise. The medication addresses the symptoms, but it does not delay the progression. You must get on an exercise routine. My first ten years were like flying and airplane on autopilot. I could get along with discomfort and keep on working. I retired and moved, and within a year it was as if the plane was plummeting to the earth. I credit this to not having enough to keep me really active. Sitting around and drinking and not eating properly , does nothing for your well being. I quickly found out alcohol is not my friend. Two glasses, in the evening, will negate all my medication that evening, and I will be talking and moving around all night. (Not good for bed partners)
It was at this point I joined the local support group. I believe strongly the value support groups and the information they can provide. You should join the national as well as local chapters near you.
Also, get a good physician who cares about you. The latest title seems to be Movement Disorder Specialist.There are a lot of physicians out there, not all of who have the same approach. You deserve qualified and competent care.

In summary, yes I believe, you can normally tell when you have progressed, but may not realize it til you are already there. I say that specifically about things like incontinance, constipation, and several other symptoms. At first it is an inconvenience Some may progress faster than others. I have been told that .by the time you can recognize the tremor, you have already lost near 80% of your Dopamine producing capability. So we will all progress eventually, but we can take measures that are productive to each of us as individuals. The other thing that could prove useful is a diary or journal. This would enable you to look objectively at what you are experiencing.

Good Luck and Stay Safe

Sometimes people seem to go years without serious progression. Other people can progress rapidly, especially if illness or accident incapacitates them for a while.

For my husband, the early stages were barely noticeable. He wasn't diagnosed until he was in stage 3, when he started festinating and falling. He has been at about the same level for the past 3-4 years.