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For those of you who can't browse, here it is: It Can Start As a Quiver - Ultimately Parkinson's may steal one's autonomy= =20 BY BELINDA 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. 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 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 they are 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 pogression and medication side effects."=20 =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.=20 "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 Their lives today began with a scientific breakdown.Think of the body as an engine and a part of the brain, the substantia nigra, as storing the oil= that lubricates the engine and makes its movements fluid," said Dickoff. "The oil is dopamine."=20 The death of dopamine-producing cells triggers the symptoms named for London surgeon James Parkinson, who described them in 1817. Nobody knows what causes the cells to die.=20 Theories lurk in unknown genetic quirks and environmental blunders.=20 "We know that in the past, natural insults such as flu viruses, poisoning with certain metals or carbon monoxide exposure have been known to cause diseases resembling Parkinson's," Dickoff said. "There is probably a genetic pre-disposition, but clear familial cases such as parent-to-child transmission remain rare."=20 Zobel is lucky. She remains on the low end of a five-stage Parkinson's ruler that edges from no visible symptoms to incapacitation. But she can't write legibly. Sometime she mumbles or her leg jerks.=20 Freel is farther along the ruler. "I take 27 pills a day to fend off symptoms that come in bunches," he said. "I can't go to concerts anymore, because I start the whole row shaking like a leaf."=20 A possible next step, a pallidotomy, isn't for him: "They don't tell you about the misses, when they go into your brain aiming for a tremor and they make a small error and hit your memory."=20 Former IBM executive Bill Thorson knew the risk: "I know two 'misses,' a friend made incoherent, the other partially blind."But he took it Oct. 26, 1994, at Atlanta's Emory University.=20 For the 10-hour surgery he was conscious to help guide surgeons around his brain. "They screwed a metal halo like the World's Fair unisphere into my skull. They bored a half-inch hole. They took a stainless steel, sound-sensitive probe, going for the spot where dopamine-deficient messages travel. They cauterized it to destroy the messages' errant passageway.=20 "They said, 'Wiggle your toe,' 'Move your finger,' to find where they were in my brain. I told them I saw a flash of light; they were too close to the optic track."=20 Finally, "They said, 'Lift your leg.' I did it easily. I wanted to run the hallway."=20 By the time Ramon Cardona was diagnosed at age 30, six years ago =97 14= years past his fumbled buttons =97 his body was a tremor mass: "It had turned into garbage."=20 L-dopa helped, then failed.=20 His severity took him to Denver's University of Colorado Health Sciences Center. On Jan. 18, 1996, he underwent a fetal tissue implant.=20 The double-blind study gave some candidates placebos. Last March, Cardona learned he got the real thing.=20 Anti-abortion groups have opposed the research.=20 "But many scientists believe it offers the best chance of cure," said Dickoff. "These cells are programmed to live a lifetime and are less likely to incite attack from the recipient's immune system."=20 Only time will tell if the transplant makes Cardona better.=20 "My 'off' periods are not as severe, but I still have 'all of the above,' " he said.=20 Cardona's operation is not the only look into the future. An abnormal gene was recently found in some Parkinson's patients.=20 Yesterday, in Manhattan, the country's oldest research network, the Parkinson's Disease Foundation, marked its 40th anniversary with an international symposium of specialists.=20 The cutting edge of research expands new-generation medications that mimic dopamine and stretch its efficacy; neuro-protective drugs that slow cell death; neurotrophic proteins that boost cell life; genetic engineering, and "stimulation" surgery that puts Pacemaker-like electrodes into the brain.=20 According to the most recent data from the National Institutes of Health, Parkinson's received $26 per patient for direct research funding. It trailed Alzheimer's, at $54 per patient, and multiple sclerosis, $158, in NIH funds.= =20 Two bills, one each in the House and Senate, would hand the NIH $100 million for research.=20 Freel sees himself as he may one day be: "Sitting in Carnegie Hall again, listening to Beethoven, a beautiful woman beside me," he fought to form the words, "is about as happy as I can imagine."=20 The people in this story will gather in Central Park on Sept. 27 for the fourth annual Parkinson's Unity Walk. Founded by Parkinson's patient Margot Zobel, the walk aims this year to raise $150,000 for research.=20 "You don't have to walk to participate," said Zobel. Participants should sign up soon. For information, call Zobel at (212) 580-6505.=20 For information about the disease, call the Parkinson's Disease Foundation, (212) 923-4792.