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Bill - the rust image caught my attention too.  I had severe anemia
about 4 years ago and have been taking iron every day since.  I have
heard that it is not a great thing to do with Sinemet and Permax and
Eldepryl.  But is it a bad thing to do?  and what is the impact?  No
doctor has ever told me to stop, but I think I could because my
hemoglobin is way up there in the very good range now.

Nancy Shlaes deGrazia (62/5)

Carole Hercun wrote:

> "The brain...spoils and rusts". Certainly a striking
> image, but a dark one. Its rather like being hit with
> a truck when you read it as early in the AM as I am. I
> think I was actually struck speechless for a moment,
> especially after all the posts yesterday re: cognitive
> impairment vs. dementia. Poetic license or do you feel
> that damaged by the disease?    Carole H.
>
> --- William Harshaw <[log in to unmask]> wrote:
> >     Reflections on Therapy
> > for
> > Parkinson's Disease:
> > Medication and Neurosurgery
> > by
> > Bill Harshaw
> >
> > Parkinson's Disease is associated with free radicals
> > which in turn are
> > associated with the deposition of iron.  The human
> > brain is encased in fat.
> > For a person with Parkinson's, the brain, which is
> > the source of the highest
> > creativity and reasoning, spoils and rusts
> >
> >  The two procedures I had - the pallidotomy in 1993
> > and deep brain
> > stimulation the following year - are much in the
> > news as Parkinson's
> > patients search out possible ways to mitigate their
> > symptoms and improve the
> > quality of their lives.  Media accounts of these
> > procedures focus on the
> > successes, sometimes spectacular, and give less
> > coverage to the patients
> > whose lives have not increased in quality.
> >
> >  Neurosurgery as a therapy for Parkinson's disease
> > continues to be both
> > experimental and controversial. Pallidotomy,
> > thalamotomy, deep brain
> > stimulation and foetal transplants haven't yet
> > reached the status of bypass
> > surgery for cardiac patients - the gold standard.
> > But it is useful to
> > remember that they are all based on what the noted
> > American physician Lewis
> > Thomas calls ‘halfway technologies'.He does not use
> > this term derisively,
> > but to point out that they do not represent a cure,
> > only better symptom
> > management.
> >
> >  Foetal transplant surgery is to the doctors an
> > extension of the current
> > ‘gold standard' of treatment, ‘dopamine replacement
> > therapy', as represented
> > by the L-dopa based medications.   However, it has a
> > number of ethical and
> > moral hurdles to clear before  becoming acceptable
> > to society generally.
> > The other procedures fall into the general category
> > of what surgeons do
> > best: "if its broke, fix it" (with apologies to Bert
> > Lance).
> >
> >  To put neurosurgery in the context of the universe
> > of treatment for
> > Parkinson's it is important to remember that
> > pallidotomy and thalamotomy
> > have been around for fifty years.  They were the
> > therapy of choice for
> > advanced PWPs.untl the mid 1960s when L-dopa was
> > discovered to be
> > efficacious.  As L-dopa gained acceptance, its
> > superiority to all other drug
> > therapies became apparent.  Neurosurgery went into
> > eclipse, not to have a
> > renaissance for a quarter century, a period which
> > saw the development of two
> > generations of a new type of drug - dopamine
> > agonists - which increase and
> > prolong the effectiveness of L-dopa.
> >  A quarter century's use of L-dopa as the medication
> > of choice demonstrated
> > its superiority in symptom management; it also
> > revealed the drug's
> > shortcomings - dyskinesia and psychiatric
> > side-effects in advanced patients
> > who were on high doses being among the more
> > significant.. In the early
> > 1990s, technological advances, the miniaturization
> > of surgical instruments,
> > a more nuanced and comprehensive understanding of
> > neuroanatomy, a new era in
> > neuroimaging and the need to provide some sort of
> > relief to advanced
> > patients led  to a renewal of interest in
> > neurosurgery - the old operations
> > being done more successfully and with greater
> > precision and the invention of
> > DBS by Alim Benabid and his colleagues in Grenoble
> > France.  Almost
> > paralleling the surgical innovation was the
> > development of a third
> > generation of agonists which, if they live up to
> > their press releases, will
> > provide a meaningful advance on current drug
> > therapy.  The procedures and
> > the drugs are at the limit of human knowledge.
> >
> >   Foetal transplantation is considered separately.
> > As a class of surgery,
> > it belongs with organ transplants - heart, lungs,
> > kidney ... the list goes
> > on.  It first showed its face in the late 1970s and
> > has been developing
> > quickly since then.  At times the pace of progress
> > seems slow to patients,
> > but the rate of change of progress has been nothing
> > short of exponential.
> > Results of a recent double blind study are every bit
> > as good as were
> > expected and parallel the results of other the types
> > of surgery   .
> >
> >  Comparing the state of therapy for Parkinson's
> > today to what it was a mere
> > quarter-century ago, the progress is staggering.
> > Before L-dopa, the
> > medications available were a variety of drugs which
> > were serendipitously
> > found to be beneficial as therapy.  They were really
> > pretty primitive. Now,
> > there is L-dopa, three generations of agonists,
> > neurosurgery and a whole new
> > array of research projects, any one of  which has
> > the potential to advance
> > treatment markedly.
> >
> >  It should be noted that every therapy has its
> > drawbacks, called side
> > effects, which range from the trivial to the
> > serious.  Some of these side
> > effects are major enough to prevent certain patients
> > from using some
> > therapies.  Indeed, there is a website on the
> > internet devoted to patient
> > accounts.
> >
> >  The implications of these advances on a broad field
> > of new and newly
> > adapted drug and surgical therapies is that
> > physicians will have several
> > arrows in their quiver when presented with a patient
> > with symptoms that
> > previously would have been intractable.  The other
> > aspect is the hope that
> > these developments engender.
> >
> >  The American philosopher John Searle noted in a
> > 1995 article:
> >
> > As far as we know the relevant processes take place
> > at the micro levels of
> > synapses, neurons and cell assemblies.  All our
> > conscious life is caused by
> > these lower level processes, but we have only the
> > foggiest idea of how it
> > all works.
> >
> > The doctors know that lesioning works and that
> > chronic stimulation works,
> > yet they do not know how or why.  That should give
> > some cause for pause.
> > The same comment can be made, to a degree, with
> > respect to drug therapy.  We
> > don't know why some drugs are  more effective than
> > others.
> >
> >  Perhaps Parkinson's disease will, in the end, be
> > found to be not one
> > condition, but a cluster of conditions with several
> > common characteristics
> > and each one having unique properties which set it
> > apart.  The existence of
> > progressive supra-nuclear palsy and multi-system
> > atrophy are two cases in
> > point.  That is why it is a very good thing that
> > there are half a dozen
> > agonists on the market and three types of surgery -
> > lesioning, stimulation
> > and transplant. One agonist or type of surgery may
> > be more effective than
> > others in different varieties of the condition.
> >
> >  Research is also yielding results on discovering
> > the causes of Parkinson's.
> > PD is caused by the death of the cells comprising
> > the substantia nigra which
> > produce dopamine.  It is not known what causes the
> > cells to die.  The
> > prevalent current hypothesis is the so-called
> > ‘double hit' theory - which
> > seems to be the case with other neurodegenerative
> > conditions as well - an
> > hereditary or genetic predisposition which can be
> > hit by an environmental
> > toxin, thus providing the double hit.  The toxin
> > could be anything from
> > pesticide and fertilizer to industrial pollutants
> > and
> === message truncated ===
>
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