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tv   Sanjay Gupta MD  CNN  October 3, 2010 7:30am-8:00am EDT

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appropriate security measures. one u.s. official says this is a very serious situation. again, we're expecting this to be a travel alert. that means be vigilant, which you should already be whether you're traveling anywhere in europe or otherwise. this is not telling people not to go to europe, not telling americans in europe they have to leave. this is a travel alert. just want to make sure people are extra aware. we'll have more top stories and live news at the top of the hour when "cnn sunday morning" continues. but right now "sanjay gupta, m.d." begins. parkinson's is like you're crossing the road and you get stuck in the middle, and you know the bus is coming, and you can't get out of the way. so you can kind of freak out, and you can kind of go, that bus is going to hit me at some point even though you don't know how fast or how big. >> welcome to a special edition
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of s.g., m.d. there's so much we don't know about parkinson's disease, exactly what causes it, for instance, and why would someone at the age of 29 start to develop the symptoms? no one knows for sure. this we do know. michael j. fox has in many ways become the handsome face of parkinson's? did you know he's had the disease for 19 years now? what is his life like day to day, and what is he planning on doing with the nearly $200 million he's raised? what can we learn from michael j. fox? he doesn't do a lot of interviews because he gets so tired, but today he had a lot to say. when i said i was going to be interviewing you, people asked me, how's he doing? again, i don't want to belabor that, but you're doing okay. >> what i was going to say was that i refer to it, parkinson's, the effect it's had on my life as a gift. people are clearly dubious about that. and kind of wonder how i can say
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that, but i qualify it as a gift that keeps on tacking, but it is a gift because it's really opened me up to more compassionate, curious, risk taking person and given me a kind of -- i wouldn't call the foundation my magnus owe ppus, it's definitely the most important thing i've ever done and will probably do in my life. >> right now when you're moving, like i see you're grabbing your left leg, are you trying to tell your left leg not to move. is that something you're constantly thinking about? >> it's like whack-a-mole. it's like the arm will go. i stop the arm, the other arm will go. get the arm, and the leg will go. cross the leg. it's going to go somewhere. so it's constantly moving it around until -- and then there will be times when i just stop and be still. right now, for example, if i wasn't talking with you, if i
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was just sitting, i'd be perfectly still. >> is that the stress part of it? >> yeah, it's just -- again, it's like the stuff that fires that tells you i want to pick up this glass, it's firing to tell me that something is required of me here, and my mind can't tell my brain what it is. >> when you wake up in the morning, is there a certain routine you have to go through? i mean, do you take your med at a certain time then? do you feel a certain way? >> well, it changes, but for the most part, when i wake up, i have a feature called dystonia, which is a rigidity and cramping. with me, it affects my feet. so strangely enough, the first thing in the morning is me clumping across the floor because i keep a hard pair of shoes right next to the bed, and i wake up and put them on. the stiffness of the shoe kind of forces the feet to behave. and then i wait probably about half an hour, 45 minutes before i -- i mean, i might take half a
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pill just to get me started, but i might wait a couple hours before -- depending what my day requires of me before i really kick in. >> things like, you know, tending to yourself, brushing your hair, brushing your teeth, those sorts of things? >> sometimes it's like holding an electric toothbrush without the necessity of a battery or charger. i just -- >> put your hand up. >> yeah, put my hand up and let it go. again, all that stuff, you just -- i'm just used to it. i'm just used to it. it's -- any of us have whatever we face in our lives, we find ways to deal and move forward. if we don't, it doesn't matter what you have, the result is going to be the same. you're not going to go forward, you're going to stag nate. >> let's take a look at how this all started. >> every morning, as long as i remember, i wake up in the morning, and i've got somewhere to go. i've got something to do.
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what am i going to do tomorrow? >> it's hard to believe it's been more than a decade since michael j. fox left the sound stage of his hit tv series "spin city" in a final curtain call. fox had first publicly disclosed his parkinson's diagnosis two years prior. the long hours on set were watching up with him, exacerbating the symptoms of his disease. >> the stress of doing the show is kind of an "x" factor, and it's going to be interesting to see this removed from the scenario and see what effect it has. >> fox's decision to step away from the cameras was a big decision for a man who grew up on screen, launching his career in the early '70s in his native canada. small film roles soon led to hollywood, and soon americans got to know him as the young republican alex p. keaton on the popular series "family ties." >> selfishness saved my life. i knew it would come in handy. >> at its peak, "family ties"
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drew in one-third of american households every week. fox's work on the series won him three emmy awards and a golden globe. it's also where fox met his future wife, actress tracy pollan. >> is that a compliment? >> the couple has been married for 22 years, and they have four children. fox's tv success propelled him to movie stardom with the blockbuster trilogy back to the future. >> marty, you made it. >> yeah. >> fox followed his role as marty mcfly with more than 20 films. >> that's a nice pig you got there. >> that's what they tell me. >> but it was on the set of the movie doc hollywood, where fox first displayed symptoms of early parkinson's disease, which eventually pushed him into a new role, that of advocate. >> the war against parkinson's is a winnable war, and i have resolved to play a role in that victory. >> fox works tirelessly in his quest for a cure for parkinson's, fighting for funding, campaigning for politicians sympathetic to his cause.
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his support for stem cell research and the quest for a parkinson's cure has at times sparked controversy. despite using his celebrity to point the spotlight in a different direction, fox hasn't left hollywood behind completely, with numerous guest appearances on tv series in recent years, fox is still a familiar face, and a line from his episode of "spin city" still rings true. >> it's going okay. i'm going to bounce back from this. it's not over, right? >> it's a long way from over. >> and coming up, the moment when michael j. fox learned his life was about to change forever. this may sound like a silly question, but are they sure you have parkinson's? "than you. "10 airbags... daytime running lamps... "onstar automatic crash response. "in case ya didn't see it, that's probably why "msn autos called the cruze "the class of its class right now. that seems pretty clear, doesn't it?" the all-new chevrolet cruze.
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this may sound like a silly question, but are they sure you have parkinson's? >> yes, to an extent, but parkinson's is this umbrella. parkinson's isn't -- in many ways, i have textbook parkinson's. in other ways, i have the idiosyncratic aspects to my experience. for example, i'm so tremendously sensitive to things. for a lot of times, the efficacy
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wears off. >> you get a tolerance for it. >> and it also comes with terrible diskinesia. but your experience is your experience. you can't push it in to fill a box, and you can't shrink it to squeeze it into a paranthetic notation that someone's made about it. it's your experience. i'm pretty sure that i have parkinson's, but what is parkinson's? >> medically speaking, parkinson's disease is pretty straightforward when you think about it. what you have is a particular part of the brain that produces a chemical called dopamine. helps with motor skills, smooth muscle movements. but the brain of someone with parkinson's disease isn't producing enough dopamine. why that happens exactly is anyone's guess, but the disease does get progressively worse of the as things stand right now, doctors can only treat the symptoms, typically with a pill
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that looks like this. it's called leva dopa, and it's the single most effective treatment to control symptoms. let me give you an idea how this works. what you have is the pill going into the bloodstream, and subsequently it goes to the brain, where it is converted into dopamine. but here's the problem. when the pill starts to wear off, the symptoms come back. sometimes they're even worse, and that all continues until the next pill is taken. eventually, you can develop a tolerance to this medication as well. though there is some progress really in trying to minimize that. it's sort of -- think of it as sort of a gel version of this particular medication. it's called dua dopa. what happens is the drug gets releaseded via tube directly into the small intestine, and patients can monitor their levels much like a diabetic does, and be alerted before it gets too severe. this is in clinical trial in the united states, waiting for approval, but already approved in 33 other countries. surgery is also a choice for
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patients not responding to medication. the most common nowadays is something known as deep brain stimulation. i want to give you a little idea of how this works. it blocks abnormal nerve signals that cause parkinson's symptoms by planting a battery operated device like a stop watch that send electrical stimulations which block the abnormal signals from ever reaching the brain. michael j. fox had an operation back in 1988. during his operation, michael was actually awake. he was actually talking to his surgeon. >> so he said, make your handshake, and i tried to, and i couldn't. i felt this disappointment that i couldn't give him what he wanted, and i said, i can't. and he said, we're done. and i said like wow. >> operation was over because they accomplished it all. >> they accomplished it all. which was just about cessation. i had a big tremor on my left side, fully on my left side and
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not on my right. so my whole life, working and stuff was about manipulating circumstances so i could pin that arm. >> put your hand in that pocket. >> put my hand in the pocket or busy with something. but it just got too much. so i had the brain surgery. and then, of course, i had the brain surgery, and it diminished the effects on my left side, but just through the progression of the disease, within a few months, by right side started. and i had made the decision not to have another brain surgery. >> i don't want to belabor the point, but if they said to you, look, it's not curative, but with stimulation we can dial it up, dial it down with magnets and possibly really alleviate some of your symptoms, why not do that? >> just a personal thing, they say they're going into my brain, i want to get it done. i don't want it to be -- i mean,
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we were joking about the book when the air hits your brain. i don't want the air to hit my brain too many times. if there's something that they can do in there that will be curative or restorative or halt progression, any kind of much more fundamental way than just a mechanical stop gap, kind of a pacemaker, which is what they have now, that's just my personal preference. i tend to lean against it. >> because you don't want to do another surgery unless there's greater promise. >> who wants brain surgery? >> i'm a brain surgeon. >> brain surgeons love it. and so, yeah, actually, maybe something will come through the pipeline that changes the picture, but for now, i'm perfectly -- in the last 20 years, if you told me this is where i'd be 20 years from now
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after my diagnosis, i would have taken this in a heartbeat. i'm very happy with my life. i'm very happy with what i'm able to do. >> a few years ago, many people, including michael, were hopeful that stem cells were going to be one of those options. why don't you talk about stem cells as much anymore? , you canm right here... or eat green giant beans at home... ...frozen within 8 hours to lock in nutrients. up to you. [ green giant ] ho ho ho ♪ green giant.
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ten years ago, michael j. fox started foundation that now has his name is find a cure for parkinson's. the foundation is now embarking on a major research project. they're looking for biomarkers for parkinson's. it's interesting because a biomarker is some sort of signal that the disease gives off, whether it's a protein or something in the body, that can serve a few different purposes. perhaps, like in the case of alzheimer's, it can give you some early clue that someone
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either has a disease, maybe doesn't have symptoms yet, or is going to develop the disease. but it may give you more insight into the disease itself. >> it gives you a starting point. if you can detect the production of the disease in a patient now, you have to wait until he's symptomatic. if you have a biomarker, you can track that from its earliest stages. you can say, what is going to be the trigger here? >> we've talked a lot about this. stem cells are something that still comes up. why don't you talk about stem cells as much anymore? >> well, it was the urgency of the moment with that vote coming up in 2006. the simple fact is that patients have the right to insist that federal funders and industry pursue anything that's likely to find an answer, to find a cure. you know, cures don't fall out of the sky. we have to go up and get them. we just assume -- like i think i
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always assumed there was a department of cures, that there was a ministry of cures, secretary of cures, but there isn't. it's us. >> such an important point. the secretary of cures he's talking about there. so many unknowns to this disease, and how close are we to finding the answers? joining me now are two of the leaders in treating and researching parkinson's disease, dr. walter kurshetz, he's deputy director of neurological issues and strokes, and dr. revina, who's a researcher with the michael j. fox foundation. he's doing well. he had a lot to say, obviously, but he did point out as well there's so many unknowns. we don't know what causes this. the treatment hasn't changed a lot over the last several years. at one point, he said just diagnosing him at such a young age, he wasn't even sure he had parkinson's disease. dr. revina, is that one of the reasons it's so difficult to make progress here. >> it's true. there are multiple factors that
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contribute to causing parkinson's disease, and certainly people who have early onset, or young onset parkinson's disease, it can be much more difficult to make a diagnosis because there's several other diseases that may be suspected or that you need to rule out first. >> the the distinguishing featu to parkinson's disease, i think the one that is the most distinguishing is that they the patients respond to the medications in the early stages. where many of the other diseases are not responsive. so this ability to respond to dope do dopamine is the point you feel parkinson's. >> he has benefit from taking dopamine, which is deficient in the brain in parkinson's. he talked a fair amount, and the foundation interested in biomarkers. tell us what biomarkers are, and why is this so important, as we move forward? >> biomarkers are characteristic
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or something that you can measure that tells you about the underlying disease process. so not the symptoms, but what's causing the symptoms. a good example is being able to measure blood sugar in diabetes, it helps you make the diagnosis, and also helps figure out if people are responding to the treatment. parkinson's disease, we really don't have biomarkers that tell us what the underlying disease is doing in the brain, and it's a little bit more challenging because the measures that we're interested in are in the brain, so it's not necessarily quite as simple as getting a blood test. >> in my mind, the biomarker significance is a measure that you can target with a drug or a therapy that increases the probability that you're going to respond to that therapy. >> five year study $40 million, several countries around the world. >> one of the first large-scale international efforts to develop biomarkers that will tell us about the progression of
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parkinson's. >> right. >> as walter was saying, exactly the point, the goal here is to be able to use these biomarkers to help develop drugs that will slow the progression. >> stem cells was something that michael j. fox used to talk a lot about, he doesn't talk as much about it. why not? is there less prom is there was a lot of enthusiasm, doctor? >> dins know there's less promise, certainly a controversial issue. the key in parkinson's weer. sue multiple different avenues. stem cells may work but there are other ways to go addressing the progression. >> the key thing to know is that the genetics has really opened the door because it isolated a defect in a protein, in a family that got parkinson's, and that opened the door because what we found everyone with parkinson's has this problem. and it occurs in the brain and in the nerves, way before you get the symptoms.
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so now, you know, we know kind of what we might be able to go after to get treatment. >> a forerunner gives you a prediction. we can all agree, he's the eternal optimist, in the book "always looking up" he calls himself an eternal optimist. why he calls parkinson's disease a gift. stay with us. ♪
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an incurable optimist. and he called parkinson's a gift, a gift that keeps on taking, as he put it. what keeps you optimistic? >> just like being in the moment. it's just like there's no more important moment than right now. and i think, you know, i say to my wife sometimes, if you -- if you get caught up in the worst case scenario and it doesn't happen, you've wasted your time, and if you are caught up in the worst case scenario and it does happen, you've lived it twice, you know? there's no -- there's no -- it's okay to be prepared and to be
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informed and to know what the future may bring, but it's also important to celebrate right now. say i golf, i'm a terrible golfer i started golfing in my 40s with parkinson's, if that isn't optimism, i don't know what is. but i just do what i want to do. and i just work with what i show up with that day. and -- but that's me. i mean, again, i'm very lucky in a lot of ways. >> what's the legacy of the foundation doing today? >> hopefully we'll accomplish our mission in some way, facilitate a solution to this puzzle.
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we know you're a big athlete and runner, so if you run the marathon, and i urge you to, run for team fox. >> he joins athletes all around the country by cheering them on, helping him find


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