Parkinson’s, Pesticides and Poverty--The Dilemma of Latino Denial

Parkinson’s, Pesticides and Poverty--The Dilemma of Latino Denial

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Photo: Félix Saldaña, above, initially ignored his tremors until a a doctor diagnosed him with Parkinson’s. (Yolanda González Gómez/HuffPost Voces)

Part 1. Read Part 2 here
In Spanish

DALLAS, Texas--Since Félix Saldaña immigrated to the United States from Mexico in 1975, his world revolved around going up and down the high pallets, wooden structures and operating machinery in his construction work, which he performed without problems for years, probably strengthened by his years as an amateur boxer in Mexico.

Over time, he became a supervisor in his company, until one day, at age 46, Saldaña began to feel his hands trembling, his legs stiffen and extreme fatigue set in. He also began to suffer frequent falls.

Saldaña thought that such discomforts were normal for his work until his sudden inability to tun his head while using equipment and he

Hispanics and Parkinson’s

The 2010 study by the University of Missouri and the American Parkinson Disease Association identified 450,000 cases of Parkinson's disease out of a data bases of 36 million Medicare beneficiaries. The researchers found that among those 65 or older, Hispanics and whites developed the Parkinson’s twice as often as blacks and Asians.

Parkinson’s disease is a common neurodegenerative condition that causes tremor, stiffness, slowness, mood and behavioral disorders, sleep problems and other symptoms. The disease is characterized by loss of dopamine, a compound involved in communication between brain cells.

Some neurologists suggest there may be a much higher Parkinson’s incidence among Latinos that is not being medically detected and diagnosed. A 1995 report by Kaiser Permanente found that Hispanics had the highest rate of Parkinson's with 16.6 cases per 100,000, followed by whites (13.6 cases), Asians (11.3) and African Americans (10.2).

One factor that may place Hispanics at increased risk of developing Parkinson's is that they are the largest, the fastest growing demograpic group of older minorities in the United States. In addition, the agricultural work or so may Latinos has exposed many to environmental pollutants and pesticides.

In addition, Latinos’ greater economic disadvantage often results in their having delayed access to information, lack of education, limited access to health care and cultural factors that make them strongly deny or identify the symptoms as part of their aging process.

Although scientists are still trying to understand potential genetic factors in causing Parkinson's, recent studies in Texas found different pesticides in the homes of pregnant Latinas living along the Texas-Mexico border, especially where there is incidence of developmental problems beginning early in life.

“Several disease experts have commented that there could be more cases of Parkinson's among Hispanics compared to other population groups and one of the key factors was less education,” said Francisco Gonzalez-Scarano, MD, dean of the School of Medicine and vice president for medical affairs at the University of Texas Health Science Center at San Antonio.

Hispanics, he observed, commonly do not recognize Parkinson’s disease, but rather relate its tremors to the effects of aging. He warned that more cases are likely to emerging in the coming years, because Latinos live longer that the rest of the U.S. population.

-- Yolanda González Gómez

“suffered two falls from heights that forced my boss to assign me other duties at ground level.”

But Saldaña ignored these symptoms for more than two years. Eventually, he became one of only 15 percent of those with Parkinson’s diagnosed before age 50. Most cases are diagnosed at age 65 or older.

Both Latinos like Saldaña and whites in the United States are twice as likely to develop Parkinson's than African Americans and Asians, according to a 2010 study by the University of Missouri and the American Parkinson Disease Association, which analyzed data from 36 million Medicare recipients.

Like many others in the Hispanic population, Saldaña had a greater tendency to ignore the symptoms of the disease partly because many mistakenly believe their symptoms are natural effects of aging.

But also, they delay treatment because they cannot afford it. Because Latinos tend not to be educated about the condition, they often miss out on resources, existing medical advances and specialized help.

Living With Parkinson’s

Saldaña recalled, “I lived those years very depressed and resisting the signals.” But the signs became increasingly noticeable work, interfering with is work. Saldaña finally agreed to see a specialist, who diagnosed him with Parkinson's disease.

“After learning I had the disease, I cut myself off from people, did not want anyone to see me because I thought they were going to make fun of me,” he said. “I hid, I was embarrassed to be noticed and greatly feared falling/. It was a long time of confusion and anguish.”

Originally from the State of Guanajuato, Saldaña, now 63, has adapted to his condition and come to accept assistance from others, especially his wife and neighbors, "because they already know I'm disabled--that is easy to see,” he joked.

Despite his slow movements, his walk is firm and stable. Saldaña attributes his considerable improvement to daily physical exercise in a gym he has assembled in a small room off the kitchen. He also swims, does yoga and goes Zumba dancing with other seniors.

“If you would have seen me 10 years ago you would not recognize me, I was much worse, almost could not walk or be as independent,” he states.

Using a specially modified steering wheel, Saldaña is still able to run errands nearby in his pickup truck. And most important, he was able to walk one of daughters to the altar at hre wedding. He proundly says he was who danced the most in the wedding party.

Despite being active, though, Saldaña has difficulty sleeping and affording the cost of his medication, which total from $300-$800 per month, even with help from Medicare, he said.

“Without my medications I may not have good mobility, because I notice when the levodopa [medicine] gradually loses its effect after a few hours. I have already been 15 years like this,” he said.

Teresa, Saldaña’s wife, also adapted to his Parkinson. “At first it was hard to believe, then we faced it, and I have learned to navigate life with this over 15 years,” she said.

Saldaña added, “The hardest thing of all is to remember the past, what I was and did. It hurts not being able to move as before. God knows why but I'm here facing this if that his will.”

Mobility Becomes New Challenge

Epigmenio Quintanilla Jr., 81, said he has lived one day at a time since he was diagnosed with Parkinson's six years ago: “It started with a strong pain in my back and loss of balance, and difficulty walking later.”

The retired geology technician recalled that his father also suffered from Parkinson’s in his hometown Laredo, Texas, near the Mexico border. “The hardest part is that this disease is consuming overall. Besides losing control of my movements and walking, I also noticed damage to my voice,” said Quintanilla, a Korean War veteran.

Such constant discomfort frequently makes him postpone the physical exercise he should perform twice a week at a nearby center for retirees. “It is very difficult to enter and exit from my vehicle to go there because the pain comes when I move,” he explains.

His wife, Helen, said Epigmenio does not like that people feel compassion towards him because of his illness, so “every day becomes a new challenge.”

The Quintanillas complained that it is hard to live with Parkinson's in the large house where they raised their two daughters, who are now adults. They have thought of going to a retirement home for seniors. Helen added, “It's hard now that I have to do everything at home.”

The couple described needing to make constant adaptations in recent years. Epigmenio commented, “I know I have an incurable condition to live with until they find a cure, so just my biggest complaint is that I can’t walk properly.” Not yet ready to use a walker, he prefers using one of his three canes for support.

“Medication and exercise are the keys, but not moving especially worsens the problems of motion and walking,” said Ingrid Pretzer-Aboff, PhD, co-director of the Parkinson’s clinic at the University of Delaware.

“Exercising is a great change of direction in treating Parkinson's disease,” Pretzer-Aboff said. It improves not only one’s mobility, but it reduced resistance to learning, while also fighting depression and anxiety in a majority of cases.

Pretzer-Aboff explained that Hispanic family members and caregivers often will help in ways that minimize how much a Parkinson patient has to move. However, she added, “We must encourage them to move more and leave the house to avoid isolation.”

Yolanda González Gómez wrote this article for HuffPost Voces through the post-fellowship for journalists on Aging, a collaboration of the Gerontological Society of America and New America Media with support from AARP.