@hopeful33250 My wife wast first symptomatic about 7 years ago. We went through a series of evaluations and diagnoses before arriving at Atypical Parkinsonism with LBD. The differential diagnosis is not easy but, in her case, was pretty clear. Cognitive symptoms were prominent early on while the typical motor symptoms were largely absent. ANS symptoms were also present from the beginning. She never responded robustly to the carbadopa levadopa formulations though she did get some relief. Over the years her course has been consistent with LBD stages. I’ve had to become quite knowledgeable about treatment, course, symptoms, medication, and management in order to effectively advocate for her. I had the advantage of a background that gave me a lot of baseline information. I’m a clinical psychologist and much of my career has been spent in healthcare settings including an inpatient physical medicine and rehabilitation unit working with patients with a variety of neurological conditions and disorders. I also knew firsthand how bad our healthcare system has become. So I knew I would have to become a fierce advocate for my wife. Frankly, I don’t know how people manage if they don’t have an advocate, especially as the disease progresses.