It Can Start As a Quiver Ultimately Parkinson's may steal one's autonomy=20

                         By LINDA YGLESIAS
                         Daily News Staff Writer

To gauge the magnitude of the first  small quiver in his left hand, 14 years
ago when he was debonair and barely 53, see him as he is today.=20

He fights his left arm wildly shaking, his left leg twisting inward with
spasms that make  him stumble when he tries to walk. He looks through his
window with gorgeous eyes, the part of him, he says, that is not turning to
bits and pieces.=20

This is the face of Parkinson's disease on Don Freel, white-haired,
blue-eyed at age 67. He no longer goes to the symphony.=20

"People manage in that first, split-second of eye contact," he says in slow,
slurred  words, "to look away."=20

Parkinson's disease is stalking with a vengeance seen on any random sidewalk
where people move with bodies stooped, hands trembling and faces frozen as
though rendered in wax.=20

"Many days I see people on the street who I know have Parkinson's, and I
wonder if they know," said Dr. David Dickoff, clinical assistant professor
of neurology at Mount Sinai Medical Center.=20

Many of them are famous. Muhammad Ali and Attorney General Janet Reno, Pope
John Paul and the Rev. Billy Graham have it. President Harry Truman and the
late actress Deborah Kerr had it. Adolf Hitler had it.=20

Most are ordinary people doing ordinary things when something, a flicker,
strikes.=20

At 2:30 p.m., Feb. 13, 1983, Freel, a high-flying computer services sales
executive, was making phone calls in his midtown apartment when his hand
began to tremble.=20

Margot Zobel, a 60-year-old computer consultant, was putting on makeup in=
 her
upper West Side bathroom 10 years ago when she dropped a tube of mascara.=20

Bill Thorson, 59, climbed from a  Westchester swimming pool 20 years ago
and felt his right foot slightly drag.=20

Ramon Cardona, 36, a single father raising two daughters in the South Bronx,
was 16 the first time he fumbled with the buttons on his shirt.=20

Each is in a stage of a degenerative, incurable brain condition that
mysteriously kills the brain-cell suppliers of the body's
movement-messenger, the chemical dopamine.=20

They are among 1 million stricken Americans, a toll rising by at least
50,000                      new cases annually, 135 per day. More  people
have it than multiple sclerosis,
muscular dystrophy and Lou Gehrig's disease combined.=20

Forty per cent who get Parkinson's are younger than 60; 30% are not yet 50,
10% not yet 40. The count will rise as baby boomers gray.=20

"I can't describe the jolt when I diagnosed  my first Parkinson's patient
who was younger than I was," said Dickoff, who also heads neurology at
Westchester's St. Joseph's Medical Center and Yonkers General Hospital. "He
was 36. I was 37. I  could see his future."=20

Even as Parkinson's invades, finding it is not a given. There is no test.
Diagnosis rides on a clinical multiple choice. The body must exhibit a
combination of features: tremors, rigidity, imbalance.=20

As likely as not, the stricken have trekked from doctor to doctor only to be
told theyare depressed, arthritic or, as Zobel puts it, "just plain crazy."=
=20

"A guy comes in with classic hypophonia, soft speech, and the doctor says
laryngitis," said Dickoff.=20

By the time symptoms stir, 80% of the  dopamine-bearing cells are dead and
the  clock to getting sicker is ticking.=20

A cure may hover, but not without a price. "We're within five to 10 years,
if there's enough funding for research," said Dickoff.=20

Time remains the enemy. Given enough, Parkinson's can doom its victims to a
vegetative state.=20

Freel, Zobel, Thorson and Cardona do not consider life down the road. They
take the dopamine-replenishing drug, L-dopa, the  backbone of treatments, to
ameliorate symptoms.=20

It is, at best, a stopgap. "You can reverse disability for five or 10 years,
or even longer," said Dickoff. "But the medication regimen may lose its
punch, and the disease again disables, this time from a combination of its
progression and medication side effects."=20

When L-dopa failed, Thorson braved a  pallidotomy, an experimental surgery
that attacks symptoms by burning a hole in the  brain's movement mechanism.=
=20

"Microscopic smart-bombs can zero in on specific symptoms based on a
reconnaissance map of the brain's circuitry," said Dickoff.=20

Cardona underwent a controversial and futuristic technique =97 a fetal=
 tissue
transplant.=20

"Living cells genetically programmed to make dopamine are harvested from
fetuses and transplanted through a tiny straw, guided by a computer, into
that part of the brain lacking dopamine," said Dickoff.=20

"I just want to quit shaking," said Cardona. "I see in the mirror a masklike
face, scary," said Zobel.=20

"Surgery made me better. Now I'm worse, desperate for solutions," said=
 Thorson.=20
"Death is not the problem," said Freel. "Living is the problem."=20


End of Part -1


                         Original Story Date: 060197
                         Original Story Section: Beyond the City

Margaret Tuchman (55yrs, Dx 1980)- NJ-08540
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