Tuesday, March 23, 2010

No pill cures all critics



If someone stays late in a neighborhood pub, sipping vodkas until even the bartender loses count, nobody will be surprised when the drinker speaks with a slurred tongue and walks on lurching feet. Folks who overdose on alcohol or drugs have made a choice to confound their brain, their nervous system, even their vision.

Friends may have a different problem with a neighbor who does not drink, but who walks unsteadily, sometimes mumbles, trips over invisible obstacles, even gags and chokes for no reason anybody can see. This is the neighbor with an incurable neurological disease called olivopontocerebellar atrophy (OPCA) or multiple systems ataxia (MSA). It is not Parkinson’s, but it is a form of Parkinsonism.

Many of its victims look fine, as long as they don’t stand up. Anybody looking at them might have no idea how risky it is for them to climb a flight of stairs, how dizzying it is to walk down the hemmed-in straightness of a theater aisle, or to drive across a bridge with steel supports rising on both sides.

You can’t blame anyone for not spotting the symptoms. Most doctors practice a lifetime without ever treating a patient for OPCA or MSA. Skilled neurologists may test a patient for a year or two before reaching a correct diagnosis.

There is no pill, no medical treatment of any kind, for the cure of this disease. Doctors may prescribe something for pain or dizziness or another symptom, but there’s nothing yet for the disease itself.

One of my friends who suffers pain and severely diminished activity because of OPCA parked in a handicapped space and walked into a pharmacy. A bystander yelled obscenities at her because she didn’t look disabled to him. Not long ago I reluctantly discontinued weekly visits by a deacon because OPCA made it impossible for me to participate as I had in the past. Even this was misunderstood by people who ought to know better, people incapable of imagining how a neurological disease may affect an unlucky patient.

Someday there will be wider understanding, and less uninformed judgment. Until then, the disdain of others is just one more symptom that can’t be stopped with a pill.

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