parkinson’s disease

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A Tale Of Two Sex Drives: Love, Marriage And Parkinson’s

(Brian Rea for The New York Times)

(Brian Rea for The New York Times)

Be careful what you wish for. That’s what Marc Jaffe learned when his lackluster sex life shifted into overdrive.

He and his wife Karen Jaffe seemed to have a pretty normal life — she was busy as a physician and he had a thriving career as a comedy writer. Together they were raising three daughters in a suburb of Cleveland. Then they learned Karen had Parkinson’s disease. This is the story of how they found equilibrium between their “seesawing libidos.”

In this week’s Modern Love podcast episode, we explore sex in marriage. Listen here.

Isn’t Parkinson’s Degenerative? How Can Michael J. Fox Be Better?

Actor Michael J. Fox in a 1988 photo (Wikimedia Commons)

“Great news,” I thought when I read that Michael J. Fox was returning to a comic television role, 12 years after he left to focus on treating his own Parkinson’s disease and funding research to help all patients.

“But how can this be? If there’s a big breakthrough in Parkinson’s disease treatment, wouldn’t we have heard about it? And if there isn’t one, isn’t the definition of a degenerative disease that it goes downhill? How can he have climbed back up again?”

Dr. Michael Schwarzschild, a Parkinson’s expert and director of the Molecular Neurobiology Laboratory at the MassGeneral Institute for Neurodegenerative Disease, kindly fielded my questions. First the disclaimers: He is not involved in Fox’s treatment, and has received grant support from the Michael J. Fox Foundation for Parkinson’s Research. Now the answer to my first query: What could it mean that Fox told ABC he “kind of stumbled onto a new cocktail of meds” that made him better enough to work again? Dr. Schwarzschild:

I heard his quote, too, and of course it’s wonderful that he’s making a comeback. In terms of what to make of this somewhat cryptic comment, I don’t think it relates to some new treatment that others don’t know about, or something newly approved and dramatic, because there isn’t anything like that.

‘Someone can improve without breaking the laws of physics about Parkinson’s disease being an inexorably progressive disorder.’

As a clinician who treats patients with Parkinson’s, your impression is right: It’s a progressive neurodegenerative disease. On average, in typical or even not-typical Parkinson’s disease, it’s inexorable.

That being said, it’s not a constant decline even though it goes in that direction, and medication can have a huge effect. Levodopa, when it came around in the sixties and seventies, took people out of nursing homes. Usually, with someone who’s getting reasonable care, you don’t expect, late in the disease, to discover some combination of currently available medications that make a huge difference. But sometimes you do.

I’ll give you a couple of examples even with approved medications in the United States. Continue reading

Gawande Vs. Kinsley: Fat Fight Between Public Intellectuals

In the online fight that has just erupted over whether New Jersey Governor Chris Christie is too fat to run for president, my money is on our local doctor/public intellectual, surgeon and writer Atul Gawande. In fact, I’d even say that his opponent, liberal pundit Michael Kinsley of former Slate and New Republic fame, has tarnished himself in my eyes on this one.

Michael posted this column, titled “Requiem for a Governer Before He’s Even In The Ring,” yesterday on Bloomberg Views, and it has received wide play. It begins:

Look, I’m sorry, but New Jersey Governor Chris Christie cannot be president: He is just too fat. Maybe, if he runs for president and we get to know him, we will overlook this awkward issue because we are so impressed with the way he stands up to teachers’ unions. But we shouldn’t overlook it — unless he goes on a diet and shows he can stick to it.

I would have been happily unaware of it except that this morning, my Twitter feed carried these tweets by Atul Gawande:

The usually wise @michaelkinsley is badly wrong to argue Chris Christie’s weight disqualifies him from Presidency

Why @michaelkinsley is wrong: 1. Moderating behaviors (eg eating) is FAR harder than ceasing bad ones (eg heroin), which is plenty hard.

Why @michaelkinsley is wrong: 2. There is no evidence skinny presidents are better or worse than fat ones. (Or maybe they undereat?)

Why @michaelkinsley is wrong: 3. Obesity may be our most difficult epidemic, as we’re genetically programmed for a starvation environment.

Continue reading