Interview with Dr. Shill at the Muhammad Ali Parkinson's Research Center
part IV
RC:
Can the disease be handled more effectively if a patient is diagnosed sooner than later?
DS:
Right now we don’t have true neuro-protective drugs. We still desperately need that. The advantage to getting diagnosed early would be most important if we had good neuro-protective strategies that could actually slow or stop progression. That being said, I think there is an importance to getting diagnosed early to reduce the patient’s worry. People struggle for a long time before they reach their diagnosis, wondering what they have and what can be causing the symptoms, going from doctor to doctor until they finally get a correct diagnosis. So I think there is an importance in early diagnosis. There’s been some thought that even the drugs that are currently available may work in some fashion to slow the progression of Parkinson’s Disease. There may be a rationale to starting therapy very early in people, even with the very first sign of symptoms.
RC:
What, based on what you hear from talking to patients, is the scariest thing about Parkinson’s Disease?
DS:
Progression. Worrying about the future. All my patients I talk to say, “If I can just stay the way I am, I can deal with this. This is the devil I know and I can cope with it.” What they worry about is two years from now or five years from now or 10 years from now, where are they going to be?
RC:
And that’s a real unknown because it’s different in different patients, right?
DS:
Right. I heard one of my senior colleagues say, “You’ve seen one Parkinson’s patient, you’ve seen one Parkinson’s patient,” which basically means that everyone’s different. Everyone progresses differently, everyone has different pattern of symptoms, so everyone really is a unique individual with Parkinson’s.
RC:
So it sounds like, while many people, yourself included appear hopeful about what has been learned -- particularly over the last 20 years since Parkinson’s has really come on the scene --
DS:
I would agree, yes.
RC:
-- that there still seems to be kind of a, “the more we get to know, the more unknown there is.” In other words, there’s a lot to be known still about Parkinson’s.
DS:
Right. So we get one battle fought and won -- say, that we can manage early Parkinson’s very effectively, but how do we keep it from progressing and how do we deal with the symptoms that we still don’t deal really well with?
RC:
What do you tell Parkinson’s patients who just tell you they’re scared?
DS:
It’s okay. It’s okay to be scared.
RC:
And if they’re here at this center, do you tell them they’re in a good place?
DS:
Yes, I always talk to my patients like we’re a team in this together. I’m on their side and we’re going to fight when different symptoms crop up, we’ll deal with them. Our whole goal is just to keep Parkinson’s a minor nuissance in your life so that you’re still going about doing the things you love.
RC:
So it really is management?
DS:
Right. Maintaining quality of life and management of symptoms.
RC:
The human element seems to play a really big part in that. You seem to have a really strong human element to balance your clinical nature. I’m guessing patients notice that and it makes a difference to them.
DS:
I hope so. A good physician should be part of the therapy. They should be part of the hope and encouragement that you’re going to do well.
RC:
Is it as simple sometimes as making a little human contact, say putting your hand on their shoulder --
DS:
Absolutely. I would suspect a good portion of my patients have been hugged.
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