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Notes and Quotes- September 19, 2021

A Disease That Will Sneak Up On You

By Tom Morrow

Historically speaking, a 19th century malady that is becoming more and more prevalent in today’s modern society is “Parkinson’s Disease.” PD is thought to occur primarily with the elderly. That’s not necessarily always the case. There are no easy explanations to its cause and it can hit all ages … even the young.

Males are more often affected than females at a ratio of around 3 to 2. When it is seen in people younger than the age of 50, it is called “early-onset Parkinson’s.”

When young people like actor Michael J. Fox, boxer Muhammed Ali, and singer Linda Ronstadt are afflicted the age factor sort of goes out the window. Fox was 27 when he was diagnosed; Ali was 38, and Ronstadt was 67, but I don’t consider any age in the sixties as “elderly.” Still, older victims such as well-known actor Alan Alda are more commonplace. I was 75 when I was diagnosed.

PD is a long-term degenerative disorder of the central nervous system that mainly affects the motor nerves. The symptoms usually emerge slowly, and as the disease worsens, non-motor symptoms become more common. The most obvious early symptoms are tremor, rigidity, slowness of movement, and difficulty with walking and keeping balanced.

By 2015, it was estimated PD affected more than 6 million people and resulted in about 117,400 deaths globally. The average life expectancy following diagnosis is between 7 and 15 years.

The cause of PD is unknown with both inherited and environmental factors being believed to play a role. Those with a family member affected by PD are at an increased risk of getting the disease, with certain genes known to be inheritable risk factors. Other risk factors are those who have been exposed to certain pesticides and who have prior head injuries. Cognitive and behavioral problems also may occur with many victims suffering from depression, anxiety, and apathy. Dementia can become commonplace in the advanced stages of PD.

Boxers such as Ali, and those sports figures who have sustained a number of blows to head often are developed PD. Football players often are victims of PD. Football organizations at all levels lately have established a number of rules and procedures to minimize head trauma.

Those suffering with Parkinson’s also can have problems with their sleep and sensory systems. The motor symptoms of the disease result from the dead cells in the mid-brain leading to a dopamine deficit. The cause of this cell death is not very well understood. Diagnosis of typical PD cases is usually based on symptoms when motor skills difficulties are the patient’s chief complaint.

The bad news at this point in time: no cure for PD is known. For those of us with PD, treatment can reduce the effects of the symptoms. Initial treatment is done typically with medications such as levodopa, or dopamine agonists. As the disease progresses, experience has shown these medications become less effective.

Actor Fox has greatly increased the public awareness of the disease. After diagnosis, Fox embraced his Parkinson’s in television roles, sometimes acting without medication, to further illustrate the effects of the condition. He has appeared before Congress without medication to illustrate the effects of the disease. The Michael J. Fox Foundation aims to develop a cure for Parkinson’s disease.

Professional cyclist and Olympic medalist Davis Phinney, who was diagnosed with young-onset Parkinson’s at age 40, started the Davis Phinney Foundation in 2004 to support PD research, focusing on quality of life for people with the disease.

Boxer Ali showed signs of PD when he was 38, but was not diagnosed until he was 42. He has been called the “world’s most famous Parkinson’s patient.” There continues to be debate on whether he actually had PD caused from boxing. At the time of his suicide in 2014, actor-comedian Robin Williams had been diagnosed with PD.

A physician initially assesses for PD with a careful medical and neurological history. Focus is put on confirming motor symptoms and supporting tests with clinical diagnostic criteria being discussed by a physician and PD specialist.

Be aware multiple causes often mimic PD making it look similar to the disease. Stroke, certain medications, and toxins can cause “secondary parkinsonism” and need to be thoroughly and properly assessed. Parkinson-plus syndromes, such as progressive palsy and multiple system atrophy should be considered and ruled out appropriately due to different treatment and disease progression.

For those losing their motor skills such as walking and difficulties in keeping balance, swallow your pride and use a walker both indoors and out. The results of a bad fall can be worse than any disease.

The above information on PD is just that … information. It is a complex disease and should be thoroughly discussed with your physician and a PD specialist to make sure you get the correct information and treatment.

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