DR. HOOK- Parkinson's: Fox helps fight a grim affliction

Michael J. Fox and I have some similarities! Okay, besides the fact that we are both short, we were both born in Canada! Yes, I was practically born in a little igloo in Canada before we moved to the US.

Let’s face it, we all love Canadians. As far as I know, there isn’t any controversy about Canada, except when you get a Canadian dime and the vending machine won’t take it. (But then again, everything is so expensive now that the dime is the new penny, and everything requires at least a quarter.)

Fox also skated– in fact, he dreamed of playing in the National Hockey League. I skate the Fox Trot on ice; he trotted into hockey players with his shoulder pads and hockey stick. Oh, the similarities won’t end!

As we all know, Michael J. Fox became a huge star on Family Ties and in great movies like Back to the Future. He even won three Emmy Awards for his role in Ties, and similarly I have won… well, okay, here the similarities end.

Unfortunately for Fox, he was diagnosed with young-onset Parkinson's Disease in 1991, and has become a huge proponent for the treatment and cure of Parkinson's Disease (PD). What has Parkinson’s done to people?

PD is a progressive degenerative disease of the brain that affects the basal ganglia– cells in the midbrain that help control movement. Millions of people have PD, but unlike Fox, it's pretty rare before the age of 40. About one percent of people over the age of 65 and 2.5 percent over age of 80 have PD. It's twice a common in men as in women.

We don’t know what causes PD. It might be genetic and possibly associated with exposures to pesticides and heavy metals. In PD, the basal ganglia die off, which leads to a lack of a chemical called dopamine. (Yes, I know dopamine sounds like an illegal drug or a former dictator of Uganda.) So movement problems develop, such as a resting tremor, called a “pill rolling” tremor, in which the thumb and index finger move to mimic rolling a pill or marble. So holding a razor can be iffy, but with the movement of shaving, the tremor goes away.

Rigidity occurs; in particular a “cogwheeling” rigidity can be felt on examination. So if I try to straighten out the arm, it feels like a rusty joint that gives and takes, gives and takes (like my stiff hips when I salsa dance). Because of “stiff” muscles movements, a person who used to have beautiful calligraphy skills can start writing poorly… well, like a doctor.

Slow movements can result to the point that even the face becomes “masked” or expressionless like people we see on C-SPAN. There's a kind of inertia– remember Sir Isaac Newton’s 1st Law of Motion? So a person with PD doesn’t move much when still, but when movement begins, it can be hard to stop. So walking can become a nightmare– such as turning around. Also a “shuffling gait” (like a Geisha’s tiny footsteps) is a hallmark of PD.

In some cases of PD, other brain pathology occurs that can cause dementia, depression, fatigue, incontinence, drop in blood pressure, sexual problems, and a slow GI system. In fact, Parkinson's Disease dementia affects 0.2-0.5 percent of people over the age of 65.

Currently, there is no cure. Treatment is pretty dismal because the medicines have side effects, and they tend to fail after about five years. That's why Michael J. Fox is really pushing hard for advancements in medicine to stop the progression of PD. For all people with Parkinson's Disease, it is a race against time. For more information, check out michaeljfox.org.