Rusty Nails
At the start we are each allotted roughly 30,000 days on earth, give or take a few thousand. The wise child heeds advice given early on, “Don’t waste them,” Yet of course we all do. Until it finally dawns on most of us that our lease on life is numbered and our account balance decreases without relent. We fritter away a good 20,000 days or so in single-minded pursuit of education, career, family, fame, fortune and whatnot until the newly wise child ponders, “Where did it all go? And, so quickly?” At some point we all must give account. Here is mine for the New Year.
At a little past middle age Mr. Parkinson came to visit. He will never leave. I have grown to understand that he is sinister, devious, relentless – he seeks and destroys a specific target in the noggin, the substantia nigra, a small colony of specialized cells within the basal ganglia region of the midbrain, which produce dopamine neurons.
In a magnificently elegant cascade of hormonal magic, the dopamine of a normal brain activates and then terminates nerve signals which coordinate fine movements of muscles throughout the body. But in Parkinson’s something goes wrong. The damage wrought by this peculiar lack of robust dopamine production is deep and permanent. Mr. Parkinson is a ruthless rascal, adding new and confounding symptoms like trophies along the now-compromised remainder of those 30,000 days.
“For want of a nail the shoe was lost,” begins an old fable attributed to Benjamin Franklin and others, “for want of a shoe the horse went lame.”
Call me a lame brain, if you must, but this isn’t funny. For want of a handful of brain cells the irreversible effects of Parkinson’s Disease fall upon a few unlucky souls each year. First come the tremors, then slowly the awful realization that this trembling is the least of the baggage one is about to carry. There is an inverse relationship between receding dopamine production and an increasing collection of neuro-physical insults – declining vocal mastery; diminishing olfactory acuity; difficulty swallowing, balancing, sleeping, writing; a stilted gait and awkward stance; a foolish countenance; depression; memory impairment; in the end, perhaps, dementia.
“For want of a horse, the rider was lost.” The impulses initiated in the thalamus to dance a jig or whistle a tune start out with the best of intentions but in the Parkinson’s brain the spark is ambushed as it enters a thicket of toxic proteins and confused ganglia. What ensues is a chaotic brain battle. PD is different in every patient, however in every instance the result is crushing fatigue, unexplainable pain and reliance on artificial measures to maintain a semblance of normalcy.
“For want of a rider the battle was lost.” The battle to train oneself to “swallow this pill on time, you dolt,” is often lost on me even though it is essential that I swallow those helpful little friends five times a day. Without medication the intricate symphony of muscles cannot play in concert; imagine the simple process of swallowing; itself a complex challenge, which can result in choking if not done properly. Another is drooling, never the most socially acceptable trait in your luncheon companion. Indeed, nearly all PD idiosyncrasies are amplified in public situations, so much so that a load of peas en route to the mouth, for instance, can easily fly off the spoon in all directions like so many hand grenades launched from a foxhole.
“For want of a battle the kingdom was lost.” It’s important at certain stages of battle to “charge” out of the foxhole. Likewise, in normal life a certain single-minded determination is required each time a person decides, for example, to stand up, walk across the room and close the window. Simple enough, unless you have a shortage of dopamine that day. Often, some PD clients stand stupefied in frozen anticipation of the first step they hope to initiate yet cannot quite muster due to the shaking and fear and paralyzing mortification.
“And all for the want of a horseshoe nail.” So much has been lost for so little cause. What caused those special brain cells to disappear? When? Was it five years ago that the offense occurred, or twenty-five? Was it genetic? Or are some people just genetically more susceptible to the first strong whiff of a pesticide? Was it in the water? Or the air? Or both? Or something else?
Researchers at UCLA are leaning toward the notion that drinking contaminated ground water over a period of time can result in many unhappy prognoses, including the verifiable spike in Parkinson’s cases in the Central Valley of California. In fact, per capita there are more newly diagnosed Parkinson’s cases in the Central Valley than anywhere else in the world. Many of the powerful chemicals that helped build an agricultural and industrial giant in the last century were thoughtlessly spilled or dumped on the very soil that percolates to a cesspool a thousand feet below our homes. Yet, mysteriously, some of it winds up in our bathtubs and soup pots.
In simple terms, Parkinson’s is a neurodegenerative disease – a movement disorder that grows worse over time. How do we fight it? We move! We task those muscles and nerves still under our conscious control to work! And work harder! And harder still! We walk, we run, we box and dance; we bike and breathe and jump and shout against the bastard with all our might. It helps! And we throw money at it! Every year we join thousands of other people across the country on Moving Day, a day set aside to raise awareness and funds for Parkinson’s research. This year in Fresno, it’s being held at Woodward Park on April 7th. If you would care to join my team, Team Bud, I would be honored to have you along. You can jump in for a dollar or a dime or more if you wish. Particulars are at movingdayfresno.org
The one acceptable thing about PD is that it progresses slower than many other diseases. This gives us time to focus our defenses, search for a cure, and at the same time appreciate the blessing that we still have a few of those 30,000 days left in the bank. And we’re alive.