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YOUNG-ONSET PD AFFECTS MANY PARKINSON'S SUFFERER: Eva Noemi Evans, 39, stands in the 114th District Courtroom in downtown Tyler where she's worked as a court officer for 17 years. Mrs. Evans was diagnosed with young onset Parkinson's disease three years ago, but few can tell. When days get stressful, Eva Noemi Evans strains to pencil on her eyeliner. She's right-handed, but years of practice prepared her to write with her left hand whenever she needs to. She's a longtime runner, but some days she's too wobbly to jog down the block. Sometimes she stumbles and falls. Other days she stays home and stretches. "I'm like any other person, it's just a little bit harder," she says. Few people know these things about her. And understandably so. It's hard to believe Eva has Parkinson's disease. At 39 years-old, Eva is poised and alert. Most days she rushes around 114th District Judge Cynthia Stevens Kent's courtroom, now in her 17th year as a court officer in downtown Tyler. During sentencing, she chats with prosecutors - Eva organizes and fills out stacks of probation paperwork, ferries documents between Judge Kent and attorneys and to the probation office. Large docket days keep her in court until 8 p.m. Eva takes three different drugs for Parkinson's three times a day to keep her limber and strong. "No I cannot do everything I used to, but I just take it one day at a time," she says, smiling. For Eva, living with Parkinson's isn't the hardest part. It was wrestling with a disease no one could name. For more than five years, Eva fought pain and rigidity on the whole right side of her body and the frightening sight of puzzled doctor after puzzled doctor. And, she's not alone. WORKING THROUGH THE DISEASE: Eva Noemi Evans, works in the 114th District Courtroom in downtown Tyler. Young onset Parkinson's disease Three years ago this month, Eva sat in the office of Dr. George Plotkin and cried. Her diagnosis of dystonia, the rigidness that's common to young onset Parkinson's disease, or YOPD, was six long years coming. "I thought, 'Oh my, somebody's finally telling me something,'" she says, almost teary. "I was so relieved to have a name for it." Plotkin, a movement disorder specialist and neurologist at East Texas Medical Center, said he's seen YOPD many times before, a disease that affects more than 150,000 people age 40 or under in the U.S. each year. But too many don't know it. "It's not rare at all," Plotkin says. "It's under diagnosed because people are looking for shaking, and most of these young onset cases don't have it." Parkinson's disease is a lack of dopa, the chemical in the brain that initiates pattern physical movements such as walking, writing or reacting to a ball thrown. Likewise, YOPD presents as rigidity, lack of spontaneous movement, staggering on their feet, and stiffness in limbs. With no tremors, it is still Parkinson's. "They say 'I have to think really hard through what I'm doing.' That's very classic," he says. Luckily, treating YOPD is often easier than the faster-acting later-life Parkinson's that often attacks the elderly, he says. Most YOPD cases have 30-plus years of manageable symptoms, and early diagnosis can prolong that. But nailing down Parkinson's disease in 20 or 30-year-olds can be hard to come by. "It's under appreciated, often people come in and it's been percolating a long time," he says. The disease is often mistaken as arthritis, orthopedic injury, cerebral palsy, multiple sclerosis, or stroke symptoms, Plotkin says. Since rigidity worsens with exercise - where a person's dopa is used up more quickly - athletes are often more sensitive to the symptoms of YOPD. In 1999, a 31-year-old Eva was training for a marathon. "I was running 18 to 20 miles non-stop - this was easy for me," Eva says. "Then my mileage started dropping." Short of breath, Eva cut down her running times - but soon enough pain increased in her right shoulder, then her right arm and right leg. As an athlete, Eva knew injuries came and went, so she rested, waiting for it to subside. Others noticed, too. "On Christmas day, my sister said, 'What's wrong?'" Eva says. "I was mixing for apple pies and my right hand was shaking badly. I hadn't noticed." At work, Eva made adjustments. She quickly picked up writing with her left hand. She arrived at dawn to work, early enough to slowly fill out long documents. Finally, a friend helped her get a doctor's appointment. "That's when the process began," she said. Years of physical therapy, orthopedic council, MRIs, carpal tunnel testing and various treatments left Eva frightened. "There was something seriously wrong," she says. "I couldn't write. I couldn't run at all. I started getting scared." She was losing hope. "After researching on the Internet for my symptoms, I asked my doctor if I had Parkinson's," she says. "He wouldn't give me an answer - he said we're trying to eliminate as many things as we can." In October of 2004 Eva was referred to Dr. Plotkin, and her life took a turn. "He said, you're young, we're going to be aggressive with treatment, don't worry," Eva says. Exercise, an important part of treatment for Parkinson's patients who are undergoing therapy, is essential again to Eva's life. She runs five times a week, lifts weights three times a week and takes Pilates. But it's not without hardship - and Eva knows over time her Parkinson's will slowly get worse. But she wants to live, she says, and finds strength in her family, in God's faithfulness and a focus on the abilities she still has, not the ones she doesn't. The fear of falling is a roadblock she faces daily. "One day I was running with my husband and I fell," she says. "He had never seen me fall, but I got up, and we walked for a block or so. But, then I took off running again!" Eva says it represented her personal resolve. "If I fall down I just get up and keep running," she says. "So that's what I do - I get up every morning, and I keep running my life." Those around her say Eva's determination is inspiring. "Even when she didn't know what was wrong, she worked so hard here," Judge Kent said. "She shows that you can still live and have Parkinson's." Eva wears a bracelet that's inscribed "Cure Parkinson's disease" on her right arm, the arm that was immobile for almost six years. This month, she was appointed president of the Early Onset Parkinson's Disease Support Group of East Texas. "Whether I want to be a part or not, I am a part," she says about her fellowship with other people with YOPD. "Why just live with this disease? Why not do something about it." Source: LAUREN GROVER Rayilyn Brown Board Member AZNPF Arizona Chapter National Parkinson's Foundation [log in to unmask] ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn