ELIZABETH FARNSWORTH: We begin with excerpts from Attorney General Janet Reno's press conference today.
JANET RENO, Attorney General: Carl has told me that some of you have inquired as to why my hand has been shaking. Over the summer, I noticed it shaking, and I thought it would go away. But I have now been to the doctor. He tells me that I have Parkinson's Disease. This is a disease that, as I understand it, attacks the cells that produce the chemical that controls muscle responses, or most muscle responses. The cause of the disease is unknown, so my doctor says, but the disease, the symptoms of the disease, can be treated by medication. It can affect, in some people it can affect both hands, there are tremors in both hands. This has so far affected only the left hand. And that's the only symptom that I have felt. I'm told that it can produce a slowness in gait, dragging of feet, some speech impairment, ability to--it can ultimately perhaps control balance, I mean, affect balance.
REPORTER: Ms. Reno, as I understand it, they've made a number of breakthroughs in the last few years in Parkinson's Disease. Is there a specific medication that's being prescribed for you?
JANET RENO: The medication that's being prescribed for me now--and I understand that there are a number of different ones and that they have to be adjusted as the disease progresses--is Sinemet--S-i-n-e- m-e-t, with a ratio of 25 to 100.
REPORTER: Ms. Reno, is this something that you had been concerned about for a long time when you said people had been asking about your welfare?
JANET RENO: My hand was shaking this summer, and I thought it would go away. I thought it was maybe you all picking on me. (laughter) But it didn't go away, and so I went and had it checked out.
REPORTER: Is there any relationship as far as your doctor told you between the strain of the job and Parkinson's?
JANET RENO: He indicated that there would be no relationship to that. I think from my reading that it can sometimes be--the symptoms can be exacerbated by stress.
REPORTER: You have made no correlation in your own mind about stress here and your shaking hand?
JANET RENO: One of the things that I noticed is during the Waco hearings I didn't see it shake at all.
ELIZABETH FARNSWORTH: Now, for some insight into the effects of Parkinson's Disease, we turn to Dr. C. Warren Olanow, professor and chairman of the Department of Neurology at Mt. Sinai School of Medicine in New York. Thank you for being with us, Doctor. You heard Attorney General Reno describe a little about what Parkinson's Disease is. Could you give us some more information on just what it is, what you know about the cause?
DR. C. WARREN OLANOW: (New York) Yes. It's a degenerative disease that selectively affects cells in the center of the brain in an area called the substantia nigra. These cells project to another area of the brain called the striatum and they release a chemical called dopamine. In Parkinson's Disease, there is a loss of these cells, usually at least 60/80 percent by the time first symptoms appear. And this is associated with a loss of the chemical dopamine. And that leads to the symptoms of Parkinson's Disease.
ELIZABETH FARNSWORTH: And you heard Janet Reno describe the symptoms. Did these sound typical to you?
DR. OLANOW: Yes, they do. The commonest features of Parkinson's Disease are tremor, particularly at rest, stiffness or rigidity, and slowness or bradi carnesio.
ELIZABETH FARNSWORTH: Do the symptoms progress slowly in somebody her age? Can you--can one predict that, or is it unpredictable?
DR. OLANOW: Well, there is variation from person to person. In general, it is a gradually progressive disorder, but hopefully, it will progress at a very slow rate, and as the attorney general stated, with proper medication, there is a very good possibility that they can be very well controlled for quite a few years.
ELIZABETH FARNSWORTH: She said she's taking a medicine called Sinemet or Sinemet. Does it make the symptoms disappear?
DR. OLANOW: Well, it can certainly improve them a great deal, and in some individuals in the early stages of the disease it can actually make them disappear. Sinemet is actually primarily comprised of a drug called levodopa. When levodopa gets into the brain, it is converted by the body's own enzymes to dopamine, which is the substance that is deficient in Parkinson's Disease. So what it is, is an attempt to replace the missing dopamine with a pill that can try to restore the levels back toward normal.
ELIZABETH FARNSWORTH: And you said it works in the early stages. Does it--do patients develop some kind of resistance to it, or a tolerance for it?
DR. OLANOW: It's not so much a resistance to it. But what happens over a period of time and in many instances, that's many years, patients develop two sorts of problems. One is a series of adverse reactions or side effects to the drug. And the other is the development of problems which don't respond to the drug possibly because they reflect degeneration of more than just the dopamine cells in the brain.
ELIZABETH FARNSWORTH: Do you see any problem with Attorney General Reno continuing in her work? She said her own doctor says that there's no reason she can't continue.
DR. OLANOW: I obviously couldn't comment on her, since I haven't seen her personally, but I think in general her point is very well taken. In the early stages of the disease, disability can be minimal, it can be very well controlled with medication, and many patients are able to function normally for many years and even continue employment.
ELIZABETH FARNSWORTH: How many people in this country have Parkinson's Disease?
DR. OLANOW: It's estimated that approximately five hundred thousand to a million people suffer from this disease.
ELIZABETH FARNSWORTH: And because the, the population is aging, there will be more and more people that will have it in time, isn't that right, because it's a disease that strikes older, mostly older people?
DR. OLANOW: Well, that's correct. In general, it begins at approximately 60 years of age. As our population ages and more people become 60, and as people live longer, what is predicted is that by the year 2040, there will be a fourfold increase in the number of patients with Parkinson's Disease.
ELIZABETH FARNSWORTH: So it's important that somebody this well known came out and said she has it and she wants to continue to work and she plans to continue to work?
DR. OLANOW: I think it's very important. Firstly, it's inspirational for other Parkinson's Disease patients. Secondly, it heightens awareness of this condition, and thirdly, it will, I think, call to people's minds the need to develop or to continue with research.
ELIZABETH FARNSWORTH: What's happening in research? I wanted to ask you about that.
DR. OLANOW: Well, there's a lot of things happening. It's a very exciting time in Parkinson's Disease research. Research is really aimed in two directions. One is aimed at trying to find some form of treatment that stops or slows progression of the disease. Such a treatment would obviously be very important for someone at an early stage of their disease, such as the attorney general. The other area of research is an attempt to introduce treatments in more advanced patients who cannot respond or be better controlled with existing medications to try and get them better and functional once again.
ELIZABETH FARNSWORTH: Dr. Olanow, thank you very much for being with us.
DR. OLANOW: You're welcome.