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Dr. Don Berns: Just finally got to read your posting regarding that young woman who is to have a pallidotomy. First of all, thank you very much for your interest in and your consideration of my opinions! Anyway, here's some of the thoughts that first came to mind when I read your posting: I assume since she has had pd since age 16 or so, her symptoms must have been getting more debilitating, thus the need for the procedure. With her permission, I'd personally be interested to know how quickly her symptoms first developed after/during this period of following the moquito truck on bicycle, as well as how quickly and in what manner they progressed afterward. (Was it a gradual onset like most of us experience, or was it more quickly, say in a matter of days, weeks, months?) And are/were her symptoms primarily shaking, rigidity, or whatever? Is she or her family aware of what the actual pesticide was that she was inhaling/ingesting (actually, that brings up the question of what is the most prevalent method of exposure, e.g., inhalation, ingestion, absorption through the skin, etc.)? Is it possible to contact the company which did the spraying, and try to assess what amount (flow rate) of pesticide and at what concentrations, the truck would have been expelling, and developing some estimate of total exposure based on these values and approximate number of exposures and their length of duration? I'm curious, because as seen in much of the pesticide info I've posted so far, the symptoms and reactions listed seemed to be based on more short term, high level exposures (which is probably similar to her situation), rather than to levels (longer term, low level) to which the majority of the population on average is exposed to. There is definitely a correlation to these more concentrated, toxic exposures and neurological symptoms, but the correlation with more minute, diffused exposures and neurological symptoms is less well established. I also find interesting the comment that she loved the smell of the pesticide spray, considering many with pd eventually suffer from loss of smell and/or olfactory hallucinations. I know there's a kind of distinct, itchy/scratchy, smell that I've experienced for quite a while, which I've always associated with being bothered by allergies or sinusitis (both of which I suffer from), and is a sign to me that I need to slow down and rest some or risk really getting sick. Also, I've suffered from a somewhat deficient sense of smell, that until I got pd, I had always associated with my sinus problems as well. But more recently, in addition to all that, I occassionally get the sensation of smelling something rather strong, and the only thing I can relate it to is dryer sheets, even tho' there may be absolutely none in the vicinity. Occassionally when this occurs, I also am more aware of my pd and sometime experience what I can only call a "strange' feeling. In the story I related previously of Dr. Callender's patient, also a high school student when stricken with on/off pd-like symptoms due to exposure to some injection insulation material being applied to her school's roof, supposedly her symptoms were/are triggered by smells as seemingly innocuous as perfume. I sometimes wonder about the pd/toxin/smell link. Perhaps some of us with pd were exposed to substances with distinct smells (or even taste possibly), and if these substances have by chance contributed to the development of our symptoms, then could it be possible that later exposures to similar smells could trigger symptoms (as in this second example) or conversely, that a period of temporarily worsened symptoms could trigger in the brain a memory of the original smell(s) which may have first led to this point? For example, men who have served in wartime, often come back suffering mental trauma that can trigger, under the right conditions, not only horrible memories and visions (hallucinations?), but also real physical symptoms (rapid heartbeat/breathing, sweating, etc.) as if they were there again reliving the episode. I wonder if a similar phenomena might not be at work regarding pd and smell. As a final comment on the smell of pesticides, I must say I can't possibly understand how that could be appealling?! I supposed that if we could find out what specifically was being used in this case, perhaps there might also be info on what this smell could be likened to (maybe since mosquitos (and bees, and...) seem to be attracted to sweet smells like perfume, maybe this pesticide had that sort of smell?) I watched a show on public TV a while back, and it had something to do with the environment and how, especially back in the 50"s etc., man thought he could do one up on nature, and control everything just a bit better than she could on her own. They showed this Alabama town (same state this girl is from, hence why I mentioned this show), and I mean every inch of it, being sprayed with DDT to protect the population from disease-carrying pests (ha! which is the lesser evil - personally I'll take my chances with nature). They sprayed EVERY car, doorway, trash can, and even the entire bodies of LIVE cows coming out of a paddock. It was absolutely amazing. I don't know if DDT was still being used in the 60's (it is now banned), when this young woman (and myself also, since I'm now 31) were growing up, but it is very toxic and is the main reason our national symbol, the bald eagle came very close to extinction (and also other species were decimated as well). Anyway, that's enough thinking for now. If I have any other ideas, I'll definitely relay them. I'd also be interested to hear of any other ideas that list members here might have. It does frighten me that there seem to be an increasing number of ever younger pd victims (or survivors, depending on one's point of view). This is exactly why I keep beating the same points to death - that if environmental factors are playing a significant role, and if they are primarily derived from human, rather than natural, sources, then we must take a serious look at our assumptions regarding disease and its treatment, and at the consequences of our culture's lifestyle. Along with developing the means to help those like this young woman, who have already suffered for many years and who would like to regain their independence and ability to contribute, etc., we must also focus on finding and eliminating the source(s) of the problem, or at the very least, find ways to protect ourselves and build up our resistance to those things which we cannot alter. As in the case of all the genetic testing, etc., now being developed, I believe one obvious benefit would be that those who are identified with susceptibilities to certain diseases, could then be forewarned and hopefully avoid those substances and/or situations which could trigger the disease. Where avoidance isn't possible, knowledge of the root cause(s) can aid in choosing the best treatment(s). Oh, one last, last comment, If they know or find out what the pesticide was that this moquito truck expelled, could it be possible to supplement her pallidotomy with some of the specific antidotes/remedies recommended for specific pesticide poisonings (e.g., chelation may be used in the case of organomercuric pesticides)? Just a thought. Again, thanks for posting this story and for your interest in my opinions and thoughts. Please also pass along wishes for a successful operation to this young woman, and let us know how things go. Wendy Tebay