Parkinson’s disease

The other day during lunchtime, my brother and I stopped for seafood at Captain Benny’s on Highway 290. We usually stop once or twice a week and know the three bartenders: Alex, John, and Dallas well. I like the place because it feels you are inside a boat and the food is pretty good. My brother and I sat down and I ordered a Corona michelada, my brother a plain Corona, no mug. The place is usually filled up with people. Many of them are regulars and you nod to them or say hello, they do the same in return. I ordered a dozen of raw oysters. When the order came, I placed my Blackberry to the side and started putting salt on them, lemon juice, and hot sauce (the way I like them).

While I was thus eating, an elderly man came and sat about 4 people away from me; since the bar is in a “U” shape, I could see him well. I would say the Caucasian man was in his 80s. He was old and wore glasses, and his hair was mostly white with some bald spots. I had seen the man several times before, but had never had a real conversation with him. I find it really difficult to start conversations sometimes. Something moved me when I saw the old man, a man who had seen too many winters and too many summers. He looked so fragile and gave an aura of being a nice man. I don’t know about you but I can tell right away when someone is genuinely nice. Time takes it toll on the human body with the passing of years, and leaves but a withered shell of what you used to be. The eyes of that senior citizen were filled with compassion and resignation. I nodded at him, he nodded back. He ordered his food and drink with some difficulty and in a couple of minutes started eating as well. I started eating a small gumbo after the oysters; when the old man started eating, it was at that precise moment that I saw that he had tremors in his hands. My heart sank.

I was sure it was Parkinson’s disease, without a doubt. Parkinson’s is a progressive neurodegenerative disease of the central nervous system (CNS) that most noticeably impairs motor skills and speech. I could see the elderly man had very slow body movement, or bradykinesia. He also moved in “bloc”, meaning he would turn his whole body instead of just his neck. His hands kept shaking, not too wildly, but enough for anyone to see. Most were oblivious. I remembered that in Dr. Hopp’s Neuroscience class, Natasha, Jeannie and I did a presentation on Parkinson’s disease. We all contributed a piece of research. We never met to discuss anything and learned everything last minute, same day the presentation was due. I was surprised that we received a perfect grade. Parkinson’s is an idiopathic disease, which is a fancy way of saying that we do not know its cause. Head blows, genetic mutations, and drugs could cause it, but that is not the case in the majority of cases. In the majority of cases we just do not know the cause. What we do know is that main symptom of Parkinson’s is due to not enough dopamine produced by dopaminergic  neurons of the brain which would allow the basal ganglia to adequately stimulate the [M1]primary motor cortex. The loss of dopaminergic neurons in the pars compacta of the substantia nigra (a structure in the midbrain) means loss of the dopamine neurotransmitter. Dopaminergic neurons project to the striatum, the “central station” of the basal ganglia, which consists of the putamen and caudate nucleus. The absence of said neurons projecting to the striatum leads to a modified and less effective neural circuit inside the basal ganglia which control movement. From having “freeways” in the basal ganglia, you now have “one-way backroads”. This indirect pathway results in hypokinesia and thus, bradykinesia (slow body movement) and rigidity.

I felt bad for the old man. I am no doctor, I don’t know how to fix such things. I wish I could. My brother paid for our meals and we headed out. As I passed the old man, I touched his shoulder and said, “good to see you, you have a great day, now.” I probably sounded all stupid, but I just wanted to wish him well. He did reply his thanks. In this world, the people we have to protect most are:

1. Children

2. The elderly

Why? Because they are very vulnerable.

Tags: Diseases