The news is still sinking in for my friend and his wife, although they can’t say it’s a big surprise. Less than a month ago, my friend was diagnosed with Parkinson’s disease. It’s not just that one of his legs sometimes shakes. It’s mostly because his mother has been living with Parkinson’s for about 35 years, and he knows this is an inheritable disease; about 15 percent of those diagnosed have a first-degree relative with the disease.
They also know that it’s a degenerative disorder of the central nervous system. (When my friend nervously pointed this out to his wife before they even left the doctor’s office, she responded, Life is also a degenerative disease!)
Somewhere between 50,000 and 60,000 new cases of Parkinson’s are diagnosed in the United States each year. The most obvious symptoms are related to movement, including shaking, rigidity, slowness of movement and difficulty with walking and gait.
Depression is also a common symptom, as we all learned after Robin Williams tragically took his life, after which it was disclosed that he had been diagnosed with Parkinson’s. It was another actor, however, Michael J. Fox, who probably first introduced the disease to the American public.
The motor symptoms result from the death of dopamine-generating cells in a region of the mid-brain, the cause of which is unknown. The treatment is thus, dopamine in various drugs and amounts. My friend’s doctor is starting him on the lowest, most common dopamine drug. I actually think he’s showing improvement already.
Despite the obvious symptoms of Parkinson’s, there is no clear test to determine the diagnosis. Neurologists perform an exam called the United Parkinson’s Disease Rating Scale, which mostly provides information that can be compared one appointment to another. The “exam” is a series of performance evaluations: Can you touch your nose with each hand, can you tap your foot rhythmically, bounce one leg at a time and can you turn your hand up and down? The doctor also watches the patient walk up and down a hallway, paying special attention to how the patient pivots and turns. This “exam” produces a number which can go up or down. In his most recent evaluation, my friend’s number climbed, an obvious indication of the disease.
But still, the only real proof of Parkinson’s disease can only be found in an autopsy.
When my friend’s mother was first diagnosed with the disease, she retired from her job and she and her husband each chose “bucket list” trips in case traveling became an issue for her. They each chose three destinations and pretty much traveled around the world. Fortunately for her, she continued to be able to travel until about six years ago.
My friend certainly can’t retire from his work; he and his wife can’t afford that. And both of them, thankfully, have traveled quite a bit over the years. Still, they’re thinking they shouldn’t put off that desired river cruise in Europe too long. One never knows.
And, now they’re beginning to consider moving from their house into a smaller, one-level residence. Suddenly, planning their futures seems more necessary!
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