THE CONDITION THAT CAN KEEP YOU GUESSING FOR YEARS: PARKINSON’S

Parkinson’s disease does not strike only the elderly. One Christmas Peter M.’s friends gave him a carefully wrapped box. Inside he found animal intestines, a heart, a liver and a do-it-yourself medical book. Although the gift was a practical joke, which he took in good humour, it reflected a perception shared by his friends that he was a hypochondriac and was taking his health too seriously. The gift was designed to poke fun at his hypochondria and perhaps shake him out of it. These friends could not work out why he no longer joined in their activities and often seemed tired and low in spirits.

Peter, who was then a banker, would organise outings or weekends away for a few couples only to find he didn’t have the energy to participate. I’d arrange a bushwalk, but when the lime came to go, I was too exhausted to put one foot in front of the other, so I would stay back at the cabin and read.’ He didn’t know what was wrong.

He attributed the constant ache in his shoulder and back to old sporting injuries and thought the fatigue was just part of getting old. But he was only in his 4()s! After a while he realised his left foot was dragging and his left arm didn’t swing when he walked. Rather, it kept a crooked position, almost as if his thumb was in his belt. Eventually he sought medical advice. The first thing the neurologist did was run tests to eliminate the possibility that he had a brain tumour or had suffered a stroke.

With those two knocked out, it seemed clear that Peter had Parkinson’s disease. His symptoms then – fatigue, a frozen shoulder and a dragging foot-are classic signs. He has since developed a tremor, muscle rigidity and bradykinesia – a slowness of movement that he describes as being like walking through treacle.

He was 50 at the time he was diagnosed; however, he could trace his symptoms back at least 10 years. There is a misconception that Parkinson’s is an older person’s affliction: not uncommonly, it first appears in people in their 40s. There are Australians in their 20s who have it, and it is also known to occur in juveniles. Peter continued to work for 2 years after his diagnosis. The bank would have kept him on, but the stress of travelling to the city and dealing with the media and the public, as his job required of him, was too demanding.

‘One thing a Parkinsonian can’t lake is too much stress,’ he says. ‘It makes the symptoms worse. So you learn to avoid stress. Before I was diagnosed, I was already doing tins without realising it. I would avoid social occasions that involved meeting new people, and I thought it was just a change in my attitude to life.’

A positive attitude is an enormous help in coping with the disease. If men pace themselves and know their limitations, they can still function in a limited framework i I they have the right attitude. Men with Parkinson’s can display a wide range of symptoms, but one of the more common is impaired dexterity. A conscious effort may become necessary to cope with previously simple chores. Writing may get progressively smaller and less legible. One man could trace his Parkinson’s through the gradual deterioration of his handwriting on the stubs of chequebooks.

Although the English physician lames Parkinson first described the disease in 1817, its cause is still unknown and there is still no single scientific test for it. Diagnosis is made on symptoms. Parkinson himself thought the disease might stem from rheumatism or bowel inflammation. Victorian doctors thought it resulted from sexual overindulgence. Another theory was that areas of the nervous system wore out at different times and some people just happened to wear out a specific section of the midbrain.

Over the years there have been dozens of new ‘cures’ for the disease, from blood-letting to hemlock to vibrating chairs, but none has worked.

The estimated 30 000 Australians who suffer from Parkinson’s have limited options. Drugs have helped thousands and kept them well for 5 to 10 years. In addition, surgical procedures once considered difficult and risky have now been refined and can restore quality of life to people severely affected by the side effects of long-term medication.

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