ALBUQUERQUE, N.M. — It was Jeff Stocker’s dentist who first noticed something was wrong. “He saw that I was starting to drag my right foot,” says the Corrales resident, 56.
He was also starting to have “crampclaw,” in his right hand. “I was holding my hand about waist high and my thumb and little finger were close together.”
Stocker went to see his doctor and was referred to a specialist who delivered the unwelcome diagnosis – Parkinson’s disease. That was about 3 1/2 years ago. In the meantime, his symptoms worsened, he had to retire from his job as a heavy equipment salesman and he filed for Medicare disability.
About the same time Stocker was diagnosed so was Stephen Bodio, 62, a freelance nature and travel writer from Magdalena, N.M.
“I didn’t realize what it was,” he says. “My wife figured it out before I did. I had tremors and balance issues, muscle cramps in my arms and legs. I thought maybe it was my age and arthritis. I was in denial.”
Bodio’s symptoms worsened until he got the Parkinson’s diagnosis and began taking medication. “After that, I pushed it back a bit and I’ve been holding steady for the last three years,” he says. “I haven’t stopped doing anything, though I’m not as agile as I was.”
That’s the thing about Parkinson’s disease. The rate at which it progresses is different in different patients, and not all people with the illness manifest all the symptoms or to the same degree, explains Dr. Sarah Pirio Richardson, an assistant professor in the Department of Neurology at the University of New Mexico School of Medicine. She also is the medical director for the American Parkinson Disease Association’s Information and Referral Center at UNM.
Parkinson’s is a degenerative neurological disorder that affects the nerve cells in the part of the brain that controls muscle movement. Symptoms may include tremors, rigidity or stiffness in the joints, slowness of movement or abbreviated movement, problems with balance, memory impairment and dementia.
“Parkinson’s generally affects people over the age of 50 but you can find it in people in their teens and 20s. The incidence increases with age,” Pirio Richardson says. About 1 million people currently live with Parkinson’s in the U.S., about 9,000 of them in New Mexico. Nationwide, there are 50,000 to 60,000 new cases diagnosed each year, she says.
A small percentage of people with Parkinson’s contract it because of a genetic predisposition, and another small percentage get it as a result of environmental links, such as exposure to pesticides, manganese, some viruses and head trauma, Pirio Richardson says. However, the cause of the vast majority of cases is “largely unknown.”
“People learn to live with the disease, sometimes for several decades, and there is no clear way to test for it – no blood test, no imaging test. Diagnosis is through taking a medical history, doing a physical exam and looking for the presence of symptoms,” she says.
One of the effects of Parkinson’s disease is it reduces the brain’s ability to produce dopamine, a chemical neurotransmitter that helps in the relaying of signals between nerve cells, and which ultimately affects body movement, she says. In addition, dopamine plays a role in a person’s mood, behavior, sleep, attention, memory, learning, motivation and sexual function.
While there is no cure for Parkinson’s, there are measures and treatments that can help, the first on the list being regular exercise, which can slow the disease, help retain muscle strength and improve or preserve balance, Pirio Richardson says.
There are also medications that help the motor symptoms of Parkinson’s by increasing the dopamine level in the brain, as well as medications that mimic dopamine and others that are converted to dopamine. Over time and as the disease progresses, she says, the medications don’t work as well and can result in complications, such as the wiggly, restless movements called dyskinesia (displayed by actor and Parkinson’s advocate Michael J. Fox.)
People who no longer respond to medications may be candidates for deep brain stimulation, a surgical procedure in which electrodes are implanted in the brain and are activated by a battery that’s surgically implanted under the skin in the chest wall. This delivers an electrical impulse to the brain and reduces symptoms.
“It can be effective seven to 10 years after implantation, but it is not a cure, does not reverse the disease, and does not improve speech or swallowing problems,” says Pirio Richardson. “It is particularly effective in reducing tremor, slowness and stiffness, and reducing dyskinesia.”
New treatments still in the experimental stage include medication delivery directly into the gut via an implanted pump, and treatments involving gene therapy.
For Stocker, who takes eight pills daily to help stabilize his Parkinson’s, any new treatments or medical breakthroughs can’t come soon enough. “It’s disconcerting because you don’t know where it will end up. One day you feel good and jump out of the chair and you’re optimistic, and the next day you’re using a cane. I still try to work out five to six days a week, and I’m still able to drive, but I can see there will probably be a day when I can no longer do that,” he says.
Bodio, who also takes eight pills throughout the day, continues to walk, lift weights and attend yoga classes. An avid outdoorsman, he also hunts and fishes, and is involved with falconry and dog coursing.
“I know it will probably get worse slowly, but I expect to still be active in 10 years,” he says. “I’ll yield stubbornly. I’m not a Pollyanna about it. I mean, hell, it’s no fun and I would rather not have it, but it doesn’t have to ruin my life.”