By Holly S. Andersen, MD
wowowow.com

It was a few summers ago when Michael told me he was writing his second book. What’s it on? "Optimism," he said. I smiled. After being in medicine for 20 years, I understood the power of optimism. Second maybe only to humor, optimism keeps people healthy and helps heal those who are not. Michael is funny, and like all funny people I know, he is smart. His natural ability to make people laugh paired with his seasoned optimism is a potent formula. I smiled because I knew this book could touch people, it would inspire. It does just that.

Always Looking Up is a candid, personal journey of an introspective, refreshingly humble man, husband, father, friend, star and now political advocate making his way through his 40s, struggling against a disease we have yet to cure. He still describes himself as the “lucky man.” He believes that whatever choices may have been taken from him because of his Parkinson’s, they have been replaced with better ones.

Michael answered a few questions for wowOwow. Read on …

wOw: What do you do for stress reduction?

MICHAEL J. FOX: Stress exacerbates my symptoms. In big public settings, I always look for an out – a hallway or a room where I can go if my symptoms get hard to control. [The book describes such an occasion when Michael is forced to leave a crowded sushi restaurant only to be stuck out in the pouring rain and mistaken for a junkie needing a fix by a dealer hiding in the alley across the street.]

I attempt to get into a certain frame of mind. A frame of mind that excludes thoughts about anything I cannot control. I also spend time with my kids. That is always a good place to be. I never regret leaving whatever I am doing for my kids.

wOw: You are so accomplished. What’s next?

MJF: I am so exhausted right now. I have just finished this book, filming "Rescue Me" and I have a television special coming up. I didn’t plan this vortex; it just happened. I want to relax and enjoy time with my family this summer. Someday there will be another vortex. I would like to write a novel – that would be fun. And I want to keep the foundation vital and forward looking. I want to help the people who become involved to find the breakthroughs we need.

wOw: What would you say to a 30-year-old man just diagnosed with Parkinson’s?

MJF: Take your time; don’t think you have to plan everything now. Try to accept it; the extent it is fact, you don’t have a choice that you have it, but you have a thousand choices of how to respond to having it. It does not define you. You are still you. You may change physically for the worst, but you may positively change emotionally, psychologically and spiritually. Inform yourself, take care of yourself, and roll with the punches.

———

More than one million Americans currently live with Parkinson’s. It is a complex disease that varies greatly among individuals. The most recognized symptom of Parkinson’s disease is tremor, but many are more severely affected by stiffness or rigidity. Slowness in movement and postural instability (impaired balance and coordination) and lack of facial expressions are common. Symptoms are often subtle and occur gradually, but in some patients, the disease is of rapid onset and progression. Many people with Parkinson’s also experience emotional changes (especially depression), sleep disturbance, constipation and difficulty chewing, swallowing or speaking. The disease most often affects people older than 50, but younger people like Michael, who was diagnosed at the age of 30, are stricken as well.
Currently, there are no laboratory tests to help in the diagnosis. The diagnosis is made from a clinical history and exam. There are likely thousands of people living with early-stage Parkinson’s in the United States today who have yet to be diagnosed.

There is no cure for Parkinson’s. Not too long ago, we viewed this disease to be rather simplistic — where one dopamine-producing cell line in the brain dies. If we could replace these brain cells, we could cure the disease. Surgeons began transplanting fetal neural cells into the brains of Parkinson’s patients, and the disease became a poster child for stem-cell research. We know now that the disease process is more complex. Like Alzheimer’s, where the hallmark of the disease is "amyloid" (protein clumps) deposition on the outside of brain cells, we believe a similar process of protein clumping is occurring inside the brain cells of patients with Parkinson’s.

Although there is no cure, treatments are available to help the symptoms of Parkinson’s. Levodopa is the most effective and prescribed drug for Parkinson’s. It is a natural substance that exists in our body. When taken in pill form, it passes into the brain and is converted to dopamine. Levodopa is often combined with carbidopa (to create the combination drug Sinemet), which protects Levodopa until it gets into the brain. A side effect of Levodopa, however, is "dyskinesia," or too much or uncontrollable movement. Always Looking Up is a journey constantly navigating between these two worlds.


The Michael J. Fox Foundation for Parkinson’s Research, founded by Michael in 2000, is dedicated to finding a cure for this disease and to ensuring the development of improved therapies for those living with Parkinson’s today through an aggressively funded (over $142 million to date) research agenda.

I have served on its board of directors for six years and was board chair of the research committee for three. It is an exceptionally run organization of talented and focused individuals who all know we are working against the clock. We are reminded of this every day — Michael is our leader, but he is also our friend. We love him and we want to get him better.

I am proud of the foundation’s work. Our approach has not only organized and transformed Parkinson’s research; it is helping to transform medical research globally. Investigative medicine is fiercely competitive. Scientists compete for recognition and scarce funding through a slow, arduous process. Important advancements in knowledge are therefore often guarded and kept secret for protracted periods. Basic science or “bench” research has always been considered the upper echelon of medical research — even when done without any recognizable or foreseeable clinical application. MJFF continually works to do things better and faster – to direct and “translate” basic science toward a clinical goal – our clinical goal; and we demand that all information gained from our grant-supported research be immediately available to all. Acknowledging that Parkinson’s is more complex than originally believed, we remain optimistic that we will find a cure.

Optimism is essential for good health. The mind-body connection is real. Positive thinking produces endorphins, our natural pain killers, and releases gamma globulin and interferon, which strengthen our immune system. People who believe they will get better do better than people who don’t. People who believe a therapy will help them respond better than skeptics. The “placebo effect” is extremely powerful, and this is why it must always be controlled for in clinical trials. We can put pacemakers into patients and never turn them on, and a significant number of these patients improve — even on objective exercise testing. The placebo effect has been shown to increase activity in the pre-frontal regions of our brains — the regions most responsible for higher thinking and emotion.

Instilling realistic optimism in my patients is one of the most important things that I do. People who have realistic optimism take better care of themselves, live longer and live better. Every study that looks at this reveals the same — people who focus on the part of the glass that is half full, do better. To quote Dale Carnegie, “Happiness does not depend on who we are or what we have, it depends solely on what we think.”

Always Looking Up will make you laugh; it may make you cry. It certainly will make you more conscious of the present, and the joy available to us in our everyday lives. You won’t feel sorry for Michael; you will want to be more like him. Michael is also the author of a previous book, the No. 1 bestseller, Lucky Man.