The Star Patient

It may be the color of her shirt, a cool placid blue, she appears serene as she settles in the chair. With pearly white thick hair and blue eyes, she holds a brown bottle in her hand. The doctor is speaking, reading the notes from the last office visit, six months ago. He reviews for the medical student, an pretty Indian-looking woman, with long dark hair and glasses who utters,

“Hmm” at appropriate spaces in the physician’s monologue. He enlightens those in the room; patients not hampered by their symptoms do not take medications, other than drugs that have some preventative value. Coenzyme Q10 is available over the counter, though the pills become expensive when taken at the recommended dose, 1200 mg/day. The patient sits across from the physician, and when he mentions the coenzyme, she declares it has been effective for her. She began taking the pills three years ago when she was first diagnosed with Parkinson’s disease. Rather than buy them from the neighborhood health food shop she buys her coenzyme online, from Willner Chemists, in New York City. Sometimes the company has sizable discounts. Also important, the 400 mg dose pills she takes is large and soft, so it slides down the throat easily.

At last the doctor asks, how is she? She is very well. How rare. Her face glows and she smiles and speaks about her life. She enjoys tutoring children, she does Tai Chi, plays ping-pong, has a stationary bike she uses daily. Her painting and calligraphy classes begin soon. She eats well. Sleep is tricky. Her spouse snores. When she is eating well she sleeps deeply. Since diagnosis though she has gained twenty pounds. Her closet is home to size eight clothes and she would like to weigh less, which means sleeping may become more of an issue.

The doctor states three years from diagnosis, the average patient’s symptoms have become bilateral. On physical examination the muscles surrounding her left wrist are supple and loose. While speaking the doctor catches a glimpse of the tremor in the patient’s right hand. The patient claims she can attenuate the tremor when it begins. In his book about Parkinson’s disease, Michael J. Fox talks about when he lost the ability to quell the tremor in his hand.

The patient remarks her advice to those with the illness,

“Tell nobody.” Her family is unaware of her diagnosis and they went on vacation together. Only her spouse knows about her illness. Before leaving she asks whether there is anything else she might do to keep the disease at bay. It seems she is doing everything she can, even her attitude is light. About exercising, the doctor recommends getting her heart rate up to eighty percent of her maximum, for her age, and keeping it there, for an increasing number of minutes, at least three times a week.

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