After that visit I still felt that things were not right. I thought back to a few months before when I had visited my dad after rotator cuff surgery and his hand trembled a bit as he sat at his desk in his tax office near Little Havana. It wasn’t until about two years later when I was visiting my dad that he told me he in fact had Parkinson’s disease. I was shocked, but more importantly hurt that he hadn’t shared this with me earlier. Apparently, he had been prescribed medication to ease the symptoms but like many afflicted with Parkinson’s, it is a degenerative brain disease that progresses slowly over time with no cure, and his symptoms would only get worse moving forward.

According to the National Parkinson Foundation (NPF) 60,000 individuals are diagnosed with Parkinson’s in the United States each year in addition to the one million already living with this disease. Across the globe, this affects four to six million people. And while, the disease itself is not fatal, complications from the condition are. The Centers for Disease Control and Prevention list it as the 14^th top cause of death in the country. Additionally, a 2010 research study showed that Hispanics and non-Hispanics were twice as likely to develop the disease compared to non-Hispanic blacks and Asians.

As I think back, perhaps there were signs that we overlooked. We often laughed about how dad walked (never swinging his arms), moved in slow motion, often had a blank look on his face when we told him a story or a joke, and hunched forward as he strolled. We all thought it was just old age – he is in his 70s after all.  However, in the year since he’s told me about his condition I feel he has deteriorated. There are small signs – some not related to Parkinson’s – but nonetheless saddening. A few times over the phone he has asked me how my kids are doing but did not say their names. When my daughter turned 6 in August, he forgot to call or send a card – which was unlike him.

For someone who left his country in his 20s, started a new life in an unfamiliar place, went from washing dishes to running the finance and marketing divisions of Asian-based computer company, traveled the world, launched several businesses, and always reinvented himself, you would never imagine that this will be his most difficult journey.  Oddly enough, of all his accomplishments, I admire the courage and strength he has to endure this next chapter of his life.  

If you are concerned your loved one might have Parkinson’s, here are 10 signs to look for (from the NPF):

1. Tremor or Shaking: Have you noticed a slight shaking or tremor in your finger, thumb, hand, chin or lip? Does your leg shake when you sit down or relax? Twitching or shaking of limbs is a common early sign of Parkinson's disease. What is normal? Shaking can be normal after lots of exercise, if you have been injured, or could be caused by a medicine you take.
2. Small Handwriting Has your handwriting suddenly gotten much smaller than in it was in the past? You may notice the way you write words on a page has changed, such as letter sizes are smaller and the words are crowded together. A sudden change in handwriting is often a sign of Parkinson's disease. What is normal? Sometimes writing can change as you get older, if you have stiff hands or fingers or poor vision, but this happens over time and not suddenly.
3. Loss of Smell: Have you noticed you no longer smell certain foods very well? If you seem to have more trouble smelling foods like bananas, dill pickles or licorice, you should ask your doctor about Parkinson's disease. What is normal? Your sense of smell can be changed by a cold, flu or a stuffy nose, but it should come back after you are better.
4. Trouble Sleeping: Do you thrash around in bed or kick and punch while you are deeply asleep? You might notice that you started falling out of bed while asleep. Sometimes, your spouse will notice, or will want to move to another bed. Sudden movements during sleep may be a sign of Parkinson's disease. What is normal? It is normal for everyone to have a night when they 'toss and turn' instead of sleeping.
5. Trouble Moving or Walking: Do you feel stiff in your body, arms or legs? Sometimes stiffness goes away as you move. If it does not, it can be a sign of Parkinson's disease. You might notice that your arms don't swing when you walk, or maybe other people have said you look stiff. An early sign might be stiffness or pain in your shoulder or hips. People sometimes say their feet seem 'stuck to the floor.' What is normal? If you have injured your arm or shoulder, you may not be able to use it as well until it is healed or another illness like arthritis might cause the same symptom.
6. Constipation: Do you have trouble moving your bowels without straining every day? Straining to move your bowels can be an early sign of Parkinson's disease and you should talk to your doctor. What is normal? If you do not have enough water or fiber in your body, it can cause problems in the bathroom. Also some medicine will cause constipation too. If there is no other reason such as diet or medicine that would cause you to have trouble moving your bowels, you should speak with your doctor.
7. A Soft or Low Voice: Have other people told you that your voice is very soft when you speak in a normal tone, or that you sound hoarse? If there has been a change in your voice you should see your doctor about whether it could be Parkinson's disease. Sometimes you might think other people are losing their hearing, when really you are speaking more softly. What is normal? A chest cold or other virus can cause your voice to sound different but you should go back to sounding the same when you get over your cough or cold.
8. Masked Face:Have you been told that you have a serious, depressed or mad look on your face more often, even when you are not in a bad mood? This serious-looking face is called masking. Also, if you or other people notice that you have a blank stare or do not blink your eyes very often, you should ask your doctor about Parkinson's disease. What is normal? Some medicines can cause you to have the same type of serious or staring look, but you would go back to the way you were after you stopped the medication.
9. Dizziness or Fainting: Do you notice that you often feel dizzy when you stand up out of a chair? Feeling dizzy or fainting can be signs of low blood pressure and can be linked to Parkinson's disease. What is normal? Everyone has had a time when they stood up and felt dizzy, but if it happens on a regular basis you should see your doctor.
10. Stooping or Hunching Over: Are you not standing up as straight as you used to? If you or your family or friends notice that you seem to be stooping, leaning or slouching when you stand, it could be a sign of Parkinson's disease. What is normal? If you have pain from an injury or if you are sick, it might cause you to stand crookedly. Also, a problem with your bones can make you hunch over.