Increasing awareness of Parkinson's

Thursday, April 14, 2005

Awareness is a good thing.

This month, most of us are aware of April showers, certainly of having to dig deep to pay off Uncle Sam. But how many of you are aware of Parkinson's disease?

It is, after all, Parkinson's Awareness Month.

With the recent death of Pope John Paul II, it may be more in our consciousness. Many of us know about Mohammed Ali. Then there is that surprisingly youthful Parkinson's sufferer, Michael J. Fox, who is stirring up the stem cell research debate. And who can forget the beloved Katharine Hepburn, famously proclaiming with her Parkinson's enhanced tremolo: "The calla lilies are in bloom!"

Not to suggest that Parkinson's is a glamorous disease of the rich and famous, fierce or pious. It is a disease that knows no snobbery.

In America alone, over 50,000 people each year get the diagnosis of Parkinson's disease. A million plus in this country are living with it.

Sixty is the average age for an initial diagnosis, but more and more, an "early onset" version of the illness is emerging, attacking the under-40 set.

Parkinson's is a "neurodegenerative" disease. The most familiar symptom is the hand tremor. Other motoric symptoms include rigidity, stooped posture, shuffling walk, and an expressionless and mask-like countenance. These result from depletion of dopamine, a brain chemical that transmits messages instructing the body how and when to move. In a Parkinson's situation, the majority of the brain cells that make this chemical die, leaving the brain in a compromised state to help the body move in a fluid and natural manner.

The bad news is that this is a chronic and progressive disease with no cure. The good news is that it is treatable.

There are new treatments afoot. One that is increasingly popular is deep brain stimulation, which delivers electrical stimulation to a precisely targeted area deep in the brain to treat some of the symptoms of advanced Parkinson's disease. Medications that replace dopamine in the body (levadopa) have been around for years and are still considered the gold standard. Unfortunately, these meds can lose their effectiveness over time and increased doses result in often intolerable side effects.

As you can imagine, any illness that is chronic and progressive and has an impact on the way you move through the world will have a considerable influence on one's emotional life.

I know one 70-year-old gentleman with a very progressed form of the disease who struggles to communicate with the outside world. His grandchildren are frightened of his immobile, mask-like face, his severe difficulty with speaking, even his visible anger at being trapped within his "Parkinson's prison."

At the other end of the spectrum is a man, diagnosed in his early 40s, who struggles with the uncomfortable feeling of people staring at him, an otherwise vital looking man, limping and "moving like Quasimodo." A high-level CEO, he has been questioned about whether his judgment and other faculties have been affected by his disease.

While up to 40 percent of those with Parkinson's will develop dementia, this is usually so only in those with an onset of the disease over 70. Depression is also common in Parkinson's. But the emotional and mental suffering comes from being cut off from others, either by prejudice or by difficulty with communication.

Awareness is a very good thing. It can be the best tool we have to repair a washed-out bridge ... or build a new one.

Dr. Michael O.L. Seabaugh, a Cape Girardeau native, is a clinical psychologist who lives and works in Santa Barbara, Calif. Contact him at mseabaugh@semissourian.com.

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