Parkinson's Is Not Just An Affliction Of The Elderly

[Murray Charters <mcharters@xxxxxxxxxxxxxx>]

Parkinson's Is Not Just An Affliction Of The Elderly
By Maria Tsigas, Times Staff Writer

Monday, February 23, 2004

ELDERSBURG - It's a regular Wednesday evening at the Shinholt household. Jeff 
Shinholt is sitting on his living room
floor picking out sheet music for Sunday's church service, while his wife Mary 
is helping Jonathan, their 7-year-old,
with his homework.

As the 41-year-old father of five sits looking through the pages of music, he 
starts playing his guitar, rehearsing a
song he's picked out for Sunday's service. He strums the guitar with his right 
hand, while holding down the strings
with his left.

Everything seems quite normal, until Jeff takes a break from playing his 
guitar, and his left hand begins to shake
uncontrollably.

"I hide it well, unless you're around me a lot or sitting across the table and 
can see my hand shake. Then you think
'Something's wrong with him,' " Jeff said.

Jeff first noticed something was wrong at the end of April 2001, when he began 
experiencing a mild twitch in the ring
finger of his left hand.

At that time his family doctor referred him to a neurologist who ran a battery 
of tests and told him he wasn't sure
what was wrong with him, but that it wasn't life threatening. The doctor also 
told Shinholt that if it got worse, he
would refer him to a movement specialist.

By October it had definitely gotten worse, said Mary Shinholt, Jeff's wife.

The mild twitch had progressed to the point where his entire left hand shook.

In November 2001, at age 39, he went to see a doctor in Baltimore who 
specialized in movement disorders.

"It was Nov. 29, 2001, Stephen's third birthday. It was a morning appointment, 
a little rainy, and I had gone down
there alone, with no expectations whatsoever," he said.

The movement specialist noticed Jeff's symptoms as soon as he walked into his 
office. Specifically, the doctor noticed
Jeff's tremor and that Jeff's eyes did not blink as often as normal.

After just minutes of observing Jeff, the specialist diagnosed him with 
young-onset Parkinson's disease, a chronic
progressive nerve disease characterized by muscle tremors, weakness, rigid 
movements, drooping posture and
expressionless facial appearance.

"I was shocked. Parkinson's wasn't even part of my thinking at the time," he 
said. "Michael J. Fox was the only one I
had heard of that was young with this disease."

He said he had no family history of the disease and no friends that he knew of 
who had it, just an elderly woman at his
church who he thought maybe had it.

He said he thought of it - as most people do - as a disease that just comes 
with aging.

"It hit me like a load of bricks, I wasn't anticipating it," he said.

His wife Mary said that after many tests and doctors telling her husband that 
he was fine and not to worry, when he
finally did see the movement specialist, naturally he was shocked by the 
diagnosis.

"The doctor told me that I had five to 10 good years, possibly," Jeff said.

But, the doctor also told him that Parkinson's does not affect everyone the 
same way, Jeff said, meaning that anything
was possible in terms of the progression of his disease.

He said that as soon as he left the specialist's office, everything began to 
sink in. As he sat in his car in the
parking lot of the doctor's office, he started to think about the disease and 
how it could limit his activity and force
him to alter his long-term plans.

But after speaking with friends and his wife, he decided that he would not 
focus on the negative long-term consequences
of the disease. And so far, Jeff said, the disease has not limited him much.

"Sometimes when I'm typing on the keyboard, I'll hit the same key multiple 
times. It's little things like that," he
said.

"I see people who have had it for a long time and they can't do simple things, 
like buttoning a shirt, shaving, cutting
their own meat. Those are real challenges," he said. "I may never get to that 
point, I don't know."

He said that at times he does wonder whether his symptoms will become so bad 
that he won't be able to button his own
shirt, but then he thinks that by that time a cure may be found or medications 
will be improved so that they provide
better relief.

Jeff said he prefers to focus his thoughts and energy on finding ways to help 
promote education about the disease.

Jeff has always been a positive person and he remains positive even after the 
diagnosis, said his wife.

"Day to day, our life is pretty normal. It has been for the past 21/2 years," 
she said, "But how I think and plan long-
term has changed."

Whenever she thinks about making long-term plans, she said she thinks about how 
her husband will be in five to 10
years.

"Nobody knows what tomorrow will bring, but we do know of a possibility that 
tomorrow could bring," she said.

Jeff said he takes medications to slow the progression of the disease and 
reduce the tremors. At his stage in the
disease, that is all he needs.

If the disease progresses, he could need stronger medications that treat the 
disease more aggressively but have serious
side effects, he said.

He said his children vary in age, and their understanding of his disease varies 
by age.

His older children, Kristin, 14, and Michael, 12, understand Parkinson's, but 
he's not sure if they really understand
the potential impact down the road.

Nathan, the 9-year old, asks what Parkinson's is. Jeff said he tells him that 
the brain messages that go to his hand
aren't getting there correctly so that causes his arm to shake.

His two youngest children, the 7- and 5-year-olds, are unaware. As long as dad 
can tickle wrestle with them, they don't
worry about much else, he said.

In January 2004, a little more than two years after his diagnosis, Jeff said 
that his left-hand tremor has gotten
worse. It's more intense and more frequent. The disease has also progressed to 
his left leg and foot. They don't
tremble like his arm, but he feels a dragging sensation in his left leg, 
especially when he runs.

In 2003, Jeff ran the 26.2-mile marathon in the Baltimore Running Festival in 
just under six hours because he wanted to
prove that his illness was not going to limit him. This year, on Oct. 16, he's 
running to educate the community on the
effects of Parkinson's, he said.

"There were periods where I didn't know what the next year would be like," he 
said, "What I've learned is, I can't
worry about next year."

And on this evening, Jeff is only worried about the upcoming Sunday service and 
making sure he's chosen good music and
has had enough practice time on his guitar.

When asked whether he worries that the tremor in his left hand will affect his 
guitar playing, he shrugs off the
question.

"If I'm on the same key for a long time, then it starts to shake, but otherwise 
it's not that intrusive to my playing,"
he said. "I'm not that good anyway, so no one notices."

For more information on the Baltimore Running Festival and to register or 
donate for the marathon Jeff Shinholt is
running in to fight Parkinson's, call Jeff at 410-842-6877 or email at 
jeffrey.shinholt@xxxxxxx

Reach staff writer Maria Tsigas at 410-857-7886 or mtsigas@xxxxxxxxxxxxx

Facts on Parkinson's

- Parkinson's disease is both chronic, meaning it persists over a long period 
of time, and progressive, meaning its
symptoms grow worse over time.

- Parkinson's disease occurs when a group of brain cells that produce a 
chemical called dopamine begin to malfunction
and eventually die.

- Dopamine is a chemical messenger that transports signals to the parts of the 
brain that control movement initiation
and coordination.

- When Parkinson's disease occurs, these cells begin to die at a faster rate 
and the amount of dopamine produced in the
brain decreases.

- Why an individual develops Parkinson's disease remains undetermined.

- The four primary symptoms of the disease are: tremor of the hands, arms, 
legs, jaw, and face; rigidity or stiffness
of the limbs and trunk; bradykinesia, or slowness of movement; and postural 
instability or impaired balance and
coordination.

- It is estimated that up to 1.5 million Americans are affected, more persons 
than are suffering from multiple
sclerosis and muscular dystrophy combined.

- Although 15 percent of patients are diagnosed before age 50, Parkinson's is 
generally considered a disease that
targets older adults.

- Parkinson's disease affects one of every 100 persons over the age of 60.

- Although there is currently no cure, there are many treatment options, 
including medication and surgery, to manage
the symptoms.

- Parkinson's disease is not a fatal illness.

Source: Parkinson's Disease Foundation and the National Parkinson Foundation Inc

SOURCE: Carroll County Times Online


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