I wonder if I could get your opinions on my symptoms. I was diagnosed with idiopathic PD just over 2 years ago and my decline has been rather more rapid than I might reasonably have expected. I have many of the classic PD symptoms from resting tremor in my right arm, to bradykinesia, very awkward gait in which I stoop forward and seem to have knees permanently bent slightly when walking which puts a lot of strain on leg and back muscles. Lots of troublesome backache, excessive saliva giving rise to drooling on my pillow during the night. Lack of flexibility, reduced manual dexterity etc, etc.
But the thing I perhaps struggle with the most is lack of strength. I literally seem to be as weak as a kitten and get completely knackered at the slightest exertion. I just don't know where this extreme weakness has come from but its very debilitating and does make me want to question, once again, whether this is normal for PD or whether it's more typical of MSA - because it does feel like my muscles are atrophying before my eyes! I joined a pilates class a year ago and still do it weekly although now, I'm unable to do about half the exercises. Getting up from a face-down position on the floor into a kneeling position, for example, I find almost impossible without help. And getting up off the sofa to a standing position is also really troublesome. I try to do exercises daily and my medication is 187.5 mg Sinemet 4 x per day.
Also, in the last 6 months my speech has become strongly affected and my voice is quieter and higher pitched than it used to be and I more often than not have a lot of trouble getting my words out. Normal conversation has become very difficult.
Is this extreme weakness and speech difficulty to be expected or do you think I could be a candidate for MSA or some other "PD+" variant?