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Northwest Parkinson's Foundation Focus: Health Care Quarterly From the Puget Sound Business Journal Center of Hope The new Booth Gardner Parkinson's Care Center is the largest west of the Mississippi Brad Broberg Contributing Writer Wayne and Urldine West drove all day to visit a new Parkinson's clinic at Evergreen Hospital Medical Center in Kirkland, but it was worth every mile. On Aug. 19, the Roseburg, Ore., couple will do-si-do together for the first time in years when Wayne, a professional square dance caller, works the Oregon State Fair with Urldine at his side. "I've got my wife back," says Wayne, his voice cracking. Urldine, 69, suffers from Parkinson's disease, but she'd been repeatedly misdiagnosed and given the wrong medicine until she underwent a comprehensive assessment at Evergreen last month. Although the couple had hoped Urldine didn't have Parkinson's, the news that she did came as a relief. "We got so many answers," says Wayne, 70. Urldine left Evergreen with new medication, an exercise routine, a speech therapy program and her self-esteem. Her tremors, which had spread from her thumb to her arms, shoulders and head, are now confined to her hand. With her balance -- and confidence -- back, she's ready to start dancing again. "They really did so much to make me feel whole," says Urldine. "I think it's going to be so much better for me." When the staff at Evergreen offered to transfer the records of Urldine's assessment to a clinic closer to the couple's home, they declined. "I wouldn't think of going anyplace else," says Wayne. And why should they? The Booth Gardner Parkinson's Care Center at Evergreen is the most comprehensive facility of its kind west of the Mississippi, says Bill Bell, executive director of the Northwest Parkinson's Foundation. The center is named after the former governor because of his work with the foundation board and because he is among the 1 million Americans who must cope with the incurable disease. The foundation and Evergreen are associates in the center. They teamed up when the foundation approached various hospitals about establishing a comprehensive Parkinson's center and Evergreen stepped forward, says Bell. In return for Evergreen running the center, the foundation is underwriting any operating losses, he says. "Usually, Parkinson's is not a money maker," says Bell. "Reimbursements are poor ... that's why there aren't a lot of specialists out there." There is a great need, however. Opened in July, the center immediately attracted a 200-person waiting list, including patients from Alaska and Montana. "Some of them are looking for a silver bullet," admits Bell. "Unfortunately, that doesn't exist yet. But at least they will come away with the tools to improve the quality of their lives." The center offers two things rarely found under the same roof -- a physician with advanced education in movement disorders and a comprehensive support staff. "By being a center, we have all of (them) in-house," says Tony McCormick, manager of neurologic services at Evergreen. "And they are all trained specialists in Parkinson's disease and that is crucial." Dr. Monique Giroux is the center's medical director. Originally schooled as a general neurologist, Giroux later won a fellowship to study movement disorders at Emory University in Atlanta. "Dr. Giroux is an extremely talented individual and a great asset to have onboard," says Bell. The opportunity to provide all facets of care to Parkinson's patients and their families lured Giroux from a job at Virginia Mason. Although tremors and stiffness are the most recognizable symptoms, the disease manifests itself in numerous other ways. "It's a physical illness and it's an emotional illness and it's a psycho-social illness," says Giroux. That's why offering a holistic set of services, not just medical attention, is so important. The center's 10-person staff works as a team to identify and address the many needs of patients and their families. The team includes an occupational therapist, physical therapist, speech therapist, nutritionist, counselor and neuropsychiatrist. "Living with a chronic illness is quite difficult for the patient and the patient's caregiver," says Giroux. "There are coping issues." The staff focuses on outcome-based care, consulting with patients and their caregivers to develop a treatment plan that provides them with the highest quality of life. "We're looking for what the person wants to do," says Giroux. Often, the most obvious problem is not the one that bothers patients most, says Giroux. "So much attention is placed on movement disorders ... but if you spend too much time on that, you miss the bigger problems the patient is suffering from." For example, Parkinson's patients often have trouble swallowing, which in turn affects their diets. Swallowing therapy helps them cope. Their thought processes also can suffer, so cognitive therapy is used to improve their concentration, organization and planning. While many patients arrive at the center knowing they have Parkinson's, others come for diagnosis, which is by itself a major challenge. With no medical tests to detect it, doctors must rely on observation. Compounding the difficulty is the number of other diseases that mimic Parkinson's, notes Giroux. Parkinson's cannot be cured, but symptoms such as tremors and extreme stiffness can be moderated by the right medication. "It's like oil for the Tin Man," says Bell. Often, however, the disease eventually grows so strong that drugs no longer work. In those cases, a surgery known as deep brain stimulation can provide relief by planting electrodes in the brain. Although Evergreen does not offer that procedure, the hospital has an affiliation with the University of Washington Medical Center, which does. Besides helping patients and their families cope with the disease, the Booth Gardner Parkinson's Care Center is striving to educate the community about the illness and improve existing strategies for delivering care, says McCormick. "I look at it as charting new territory." Copyright 2000 American City Business Journals Inc.