u/mothernatureisfickle

TLDR: Is my 71 year old Mom's second opinion movement disorder neurologist's approach appropriate vs the first movement disorder neurologist's opinion amid a family history of PSP.

My Mom is a 71 year old female with a left side hand/arm constant tremor and extremely mild almost not noticeable gait issue on the left leg (only I - her adult kid - her two movement disorder neurologists and her LSVT BIG physical therapist have also recognized this gait issue). These symptoms started three years ago and the tremor has developed, but at her first neurology appointment two months ago and her PCP appointment three weeks ago she was very firm that she did not want to start medication because it did not bother her enough. The tremor is very obvious. She does have mild memory issues but my husband and cannot decide if those are age related. She denies them completely. She has fallen three times and she is adamant that all three times were from the ground being uneven, holes in the yard or the road being off. I was not there, so I cannot say. For background information my maternal grandmother died of PSP, diagnosed by autopsy when her brain was donated after her death through CurePSP.

After an evaluation, the first movement disorder neurologist diagnosed my mom with stage one parkinson's, tremor dominate. He gave my mom the option of medication, but my mom declined. He told my mom to continue her robust social and volunteer life and keep going with her daily exercise, but try to incorporate some aerobic activity (my mom was not happy about this because she does walk 2 miles per day but her heart rate never increases - we share apple watch fitness data with each other). Their office does not recommend the physical therapy to patients unless they are in wheelchairs, so that was something I discovered on my own and my Mom's PCP sent a referral for her.

We had a second opinion with another movement disorder neurologist in another city that my Mom's friend, who has advanced parkinson's, treats with. He did all the same evaluations the first neurologist did. He noticed the same gait issues and the obvious tremor. This neurologist does not use the stage system (he says it's misleading?) to diagnose patients and he told us he cannot clinically confirm my Mom's diagnosis. He suggested my Mom start taking carbidopa/levodopa and that if it helps her tremor we will have better confirmation of her diagnosis "under the parkinson's umbrella". My Mom immediately agreed. He started her on the medication today and it will take her 6 weeks to reach a therapeutic dose. I did ask this neurologist about aerobic exercise vs non aerobic exercise and he told us it does not matter because some patients cannot get their heart rate up (my Mom is not one of the patients who are unable to have an increased heart rate because both her PCP and her LSVT physical therapist have told her she NEEDS to do aerobic exercise). I was a little surprised by this.

A note to say both neurologists confirmed for me twice (because I asked) that they are as confident as they can be that my Mom does not have PSP.

I am very new to this world and my Mom is extremely independent. She is newly widowed and this diagnosis added quite a bit of anxiety to her world (rightly so) and I want to know if this second neurologist is on the right track. My Mom wants to stick with him and if this is who she is comfortable with then I need to learn more.

Does anyone know why Bronson specialists do not accept referrals from physicians outside Bronson? This is the most ridiculous closed loop system ever.

My PCP is not a Bronson doctor because seeing a Bronson PCP is so painful I’d honestly just rather be sick. When I recently needed a test that required a speciality doctor they would not accept the referral from my PCP because she is not in the “Bronson family”.

Why does Bronson do this? Is there a way around it short of having a secondary PCP as a backup for referrals just in case? If I go to a Bronson fast care can they send in a referral for a very obvious need for a test?

Should I just give up and go to Borgess/Ascension/Beacon?

My Dad purchased a Husqvarna riding lawn mower (he called it a tractor) when my parents purchased their house about ten years ago. I have no idea how he picked that specific tractor, but it was orange and every year it was a gamble as to whether it was going to start. He probably had it serviced twice over the ten years. My Dad died in December of 2024 and slowly my 71 year old Mom has been starting to pick back up with household tasks and mowing the lawn is on her list for this year. Her brother took care of it while she was dealing with my Dad's death. Unfortunately we went to start the tractor and realized my Mom needs a new tractor.

Now, my Mom is an active and on the go lady, but she does have mild parkinson's. She does use a battery powered lawn mower to mow a very small fenced in portion of her yard near her front door, but her larger front yard and the back yard total about one acre and she has her heart set on another tractor. I want her to have something that is comfortable and safe and easy to use. We will make sure it gets serviced yearly, so I'm not worried about maintenance.

She doesn't have a budget exactly, but I know she wants to spend as little as possible and still get a tractor. I tried to prepare her that she might have to spend over $3,000 or more. I need information, so I can go into this fully aware of what questions I need to ask and what I need to be looking for. What type of engine is best? What features does she need? What brand? Do we buy an extended warranty (is that a thing)? Should we buy a used tractor from a dealer?

Any help would be greatly appreciated.

My husband lost 75 pounds over the last year and has gone from a size 42 waist to (we think) a size 34. For some reason a few 34 shorts he has from a LONG time ago are too big and a 34x30 pair of Levi's is tight initially, but fits great after an hour, while the 36x30 Levi's are just too big. Also, we think he wears a size medium shirt.

He works from home, so he usually wears athletic wear which has very casual sizing, but his boss just announced the entire company is traveling to a conference in August. Short of him showing up in running clothes, he needs a few new pairs of pants and a few new shirts.

Even though he has lost weight, he has always lifted weights so his thighs are big and he has a bubble butt. The only jeans that have ever worked for him are Levi's athletic style. The man literally radiates heat, so I wanted to stay away from heavy cotton chinos. He holds a title at his company so he will be busy at this conference moving and talking to people so he needs to be and feel comfortable. It is a more casual field, so he does not need to wear a blazer or shirt and tie.

Does anyone have any suggestions of brands? I will need to order more than one size, so companies with good exchange policies are preferred.