Parkinson's, Dementia & the Insurance Fight Nobody Talks About

SHOW NOTESDr. Sulagshan "Shaun" Mahendrarajah is a board-certified neurologist practicing in Bakersfield, California, currently opening his own neurology clinic at Doctor's Park (Ming Avenue and New Stine Road). Born in Sri Lanka and raised in Montreal after his family fled the civil war, he trained in the Netherlands Antilles, completed clinicals in Chicago, and did his residency at the University of Iowa before practicing in Oregon, Texas, and now California.In this conversation, he and Dr. Civelli cover:The physical signs that let a trained neurologist diagnose Parkinson's on sight, including decreased blink reflex and masked facial expressionNon-motor early warning signs: loss of smell, constipation, REM behavior sleep disorder, and shrinking handwritingHow the DaT scan and PET scan have changed diagnostic confirmation for Parkinson's and Alzheimer'sThe role of exercise in slowing both Parkinson's and Alzheimer's progression, based on his own patient outcomesThe frustrating reality of insurance denials, peer-to-peer reviews, and step therapy requirements for dementia and Parkinson's medicationsApoE testing and the bleeding risk considerations behind infusion therapies for Alzheimer'sFunctional medicine and genomic testing as a cash-pay option in his upcoming practiceHis personal meditation practice, tied to Hindu tradition and a two-week trip to Varanasi, IndiaThe concept of svadharma, or true calling, and how it shaped his decision to leave a hospital job and open his own clinicHis father's story of being tortured while fleeing the Sri Lankan civil war, and the survivor's guilt that follows his family's story