April 5, 2014 by
Photography by Bill Sitzmann

Mike Egger, 66, has always enjoyed tinkering around the garage, maintaining his cars and lawn equipment and doing just about anything mechanical. Since he developed Parkinson’s disease some 20 years ago, these are some of the things he still enjoys most in life, but they also serve another purpose. They help keep his body and mind active—essentials in helping control the symptoms of Parkinson’s disease.

Parkinson’s is a progressive disorder of the nervous system that advances slowly and affects movement, muscle control, and balance. It is the second most common nervous system disorder after Alzheimer’s disease.

It is estimated that as many as 3 to 4 percent of the population will develop Parkinson’s symptoms during their lifetime and the risk is even higher in Nebraska. “While we don’t have a cure for Parkinson’s, we continue to make progress in diagnosis and treatment,” says John Bertoni, M.D., Ph.D., neurologist and director of the Parkinson’s Clinic at The Nebraska Medical Center. “We are continually learning more about the disease and there are many new treatments coming down
the pipeline.”

People may have Parkinson’s for many years before it becomes apparent, notes Dr. Bertoni. Some of the more subtle early-stage symptoms include: loss of sense of smell, thrashing in sleep, depression, loss of facial expression, excessive sleepiness during the day, constipation, shortening of one’s steps, and a diminishing arm swing when walking. Other symptoms include slowness, rigidity, and tremors at rest.

Mike and his wife, Mary, believe that Mike probably had Parkinson’s disease for about 10 years before he was actually diagnosed.  “I had noticed a change in his gait, one of his arms wasn’t swinging much anymore, and he had developed a slight tremor in one of his hands,” she says. The signs were so slight, however, that she attributed them to an old injury caused by falling off a horse.

As the symptoms became more pronounced, Mike saw a doctor and was diagnosed at age 50 with Parkinson’s. “The disease progressed so slowly at first that I barely noticed it, or maybe I was in denial,” he says.

Initially, Mike took medications to help control his symptoms. Most people with Parkinson’s can get significant control of their symptoms with medications and a combination of other therapies including occupational therapy, speech therapy, nutrition counseling, support groups, and
regular exercise.

Medications can help alleviate problems with walking, movement, and tremors by increasing the brain’s supply of dopamine. In Parkinson’s disease, certain nerve cells (neurons) in the brain gradually become sick. These neurons are responsible for producing the chemical messenger dopamine. A reduction of dopamine levels causes abnormal brain activity, which can lead to the symptoms of Parkinson’s disease.

“Recent studies have revealed that people who are not over-treated with medications do the best in the long run,” says Dr. Bertoni. “We have also found that those who take an active role in their own care, who exercise regularly, stay engaged, and participate in support groups, do the best in managing the disease and living a relatively healthy, active, and quality life.”

Mary, who is the president of the Nebraska chapter of the American Parkinson’s Disease Association (APDA), says that the organization offers more than 20 support groups throughout the state for both Parkinson’s patients and their caregivers.

As Mike’s disease continued to progress, he eventually had to quit work. The medications also became less effective, and the side effects of the drugs grew to become worse than the symptoms themselves, a common problem among people who have been taking medications for many years.

When Parkinson’s disease patients stop responding to medications, a surgical procedure called deep brain stimulation may be considered. Deep brain stimulation involves implanting an insulated wire into a target area of the brain. The lead is connected to a small pulse generator implanted beneath the skin, which generates mild electric pulses to the brain to reduce Parkinson’s symptoms, including tremors.

Mike had the procedure performed nearly two years ago and says it has essentially eliminated his tremors. His biggest challenges include trying to walk steadily and maintaining his balance. Aside from that, Mark says, “I still do everything now that I’ve always done, but I don’t do them quite as well and not as fast.”

While a definitive cause for Parkinson’s has not been found, a combination of factors may play a role, notes Dr. Bertoni. These include aging, having an inherited gene, and exposure to environmental triggers. Some speculate that the relatively higher incidence of the disease in Nebraska may be due to exposure to farm chemicals.

Despite some of the daily challenges of dealing with Parkinson’s disease, Mike continues to maintain a positive attitude. “I figure there are many people who have worse things than me,” he says. “I just try to roll with it and stay positive.”

The APDA assists people throughout the state. Visit parkinsonsne.org or call 402-393-2732 for additional information.

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