WEBVTT - Case #14: Maria 0:00:04.640 --> 0:00:08.080 I was having a hard time parking between two cars. 0:00:08.320 --> 0:00:08.520 Yep. 0:00:08.960 --> 0:00:12.320 Everybody was saying, your eyes are fine, your vision is fine. 0:00:12.720 --> 0:00:16.360 How can it be fine? I cannot dry and. 0:00:16.400 --> 0:00:19.280 Just you know, watching her personality change a little bit, 0:00:19.320 --> 0:00:24.360 because when you're you don't feel good, everything starts magnifying. 0:00:25.480 --> 0:00:29.760 She was telling me that sometimes she had difficulty holding objects, 0:00:30.320 --> 0:00:32.680 and she felt that her gait had changed. 0:00:32.720 --> 0:00:36.560 So that's what I picked up. Initially, I was exhausted. 0:00:36.600 --> 0:00:38.640 I had hugged down my hours at work. I was 0:00:38.680 --> 0:00:42.240 no longer taken call. I couldn't sleep, I was falling 0:00:42.320 --> 0:00:42.800 By then. 0:00:48.320 --> 0:00:51.920 How terrifying would it be to fight an unknown enemy, 0:00:52.440 --> 0:00:56.280 one you didn't recognize and didn't see coming. What if 0:00:56.320 --> 0:01:00.400 that enemy was coming from within a disease that even 0:01:00.520 --> 0:01:06.160 doctors couldn't identify. Nearly half of all Americans suffer from 0:01:06.240 --> 0:01:10.920 some chronic illness, and many struggle for an accurate diagnosis. 0:01:12.000 --> 0:01:18.679 These are their stories. A Lauren Brat Pacheco, and this 0:01:19.080 --> 0:01:37.200 is symptomatic. Doctor Maria de Leone's charismatic and creative personality 0:01:37.440 --> 0:01:40.360 instantly rubs off on you something that you may not 0:01:40.480 --> 0:01:44.480 expect from your typical neurologist. What are your passions. 0:01:44.520 --> 0:01:45.199 What do you love? 0:01:45.560 --> 0:01:45.840 Oh? 0:01:45.959 --> 0:01:48.840 I love you know, it's funny because I'm really a 0:01:48.960 --> 0:01:51.480 fashion east at heart. I mean, I look at today, 0:01:51.600 --> 0:01:58.080 but I love fashion colors and traveling and learning new languages. 0:01:58.160 --> 0:02:02.440 I speak for languages. I've been trying to learn Turkish. 0:02:02.560 --> 0:02:05.760 I started during the pandemic, so you know, I'm getting 0:02:05.800 --> 0:02:07.560 a little bit better, but it's still I said. I 0:02:07.640 --> 0:02:09.160 told my husband, I said, I need to go to 0:02:09.360 --> 0:02:11.800 you know, Turkey, so I can practice the language. 0:02:11.840 --> 0:02:14.720 Since so, which four languages do you speak? 0:02:15.400 --> 0:02:19.280 I speak some Italian and French, on of course Spanish, 0:02:19.400 --> 0:02:21.680 and then you know English, and now well, I guess 0:02:21.680 --> 0:02:23.360 with the language will be with the Turkish. 0:02:23.960 --> 0:02:28.280 Maria definitely leads a multifaceted life. One aspect of her 0:02:28.360 --> 0:02:32.280 is an incredibly intelligent and curious doctor focused on treating 0:02:32.320 --> 0:02:35.079 not only the symptoms, but a person as a whole. 0:02:35.760 --> 0:02:40.480 She also proudly presents as a self described diva. How 0:02:40.480 --> 0:02:43.000 would you describe Maria as somebody who hasn't met her, 0:02:43.000 --> 0:02:44.840 Tell me a little bit about what you love about 0:02:44.840 --> 0:02:45.640 her personality. 0:02:46.200 --> 0:02:50.600 Oh, Maria is just the most bubbly, vivacious person. 0:02:51.360 --> 0:02:55.640 That's Janet, Maria's longtime friend and an integral part of 0:02:55.680 --> 0:02:56.600 her support system. 0:02:57.280 --> 0:03:01.880 Just the sweetest, most generous person I've probably ever met. 0:03:02.600 --> 0:03:05.120 She will put it, you know, somebody else's concerns above 0:03:05.120 --> 0:03:06.640 her own, any day of the week. 0:03:09.200 --> 0:03:13.720 A fashionista and dedicated, driven doctor, Maria would have no 0:03:13.919 --> 0:03:19.040 idea that a complex and unpredictable diagnostic journey would eventually 0:03:19.200 --> 0:03:22.320 upend her life. She first fell in love with the 0:03:22.360 --> 0:03:26.240 field of medicine during a memorably captivating college lecture. 0:03:26.840 --> 0:03:31.359 My professor he must have had somebody in his family 0:03:31.639 --> 0:03:34.760 or some relation, because he would talk about Parkinson's all 0:03:34.840 --> 0:03:38.320 the time, and one of his lectures he was talking 0:03:38.360 --> 0:03:42.680 about fetal brain transplantation, and I said, right then and there, 0:03:42.800 --> 0:03:44.240 I'm going to medical school. 0:03:44.840 --> 0:03:46.360 I want to be a neurosurgeon. 0:03:46.600 --> 0:03:48.800 I want to do that kind of surgery to help 0:03:48.800 --> 0:03:50.040 people with Parkins's. 0:03:51.120 --> 0:03:53.800 She spent the first decade of her career in Pennsylvania, 0:03:53.920 --> 0:03:57.200 falling in love with the Philadelphia area, but East Coast 0:03:57.200 --> 0:04:01.120 winters would ultimately drive her back west her early thirties, 0:04:01.440 --> 0:04:05.640 where she'd open her own practice in Nakadochas, a small city. 0:04:05.440 --> 0:04:06.560 In East Texas. 0:04:06.880 --> 0:04:09.960 That's where she first met Janet and her husband Mark. 0:04:10.360 --> 0:04:14.520 Both were ecstatic to have a local neurologist, so. 0:04:15.040 --> 0:04:19.400 Mark, it was my first patient in Parkins is also 0:04:19.440 --> 0:04:23.039 my first patient in the small town community. He was 0:04:23.080 --> 0:04:27.040 a godsend because he was the loveliest, nicest person, the sweetest, 0:04:27.040 --> 0:04:30.120 you know. As soon as we got here, he had 0:04:30.279 --> 0:04:33.080 round up everybody for me, everybody he knew that had 0:04:33.120 --> 0:04:36.360 any kind of neurologic disease, especially if he thought they 0:04:36.400 --> 0:04:37.960 had you know, parkins as. 0:04:38.000 --> 0:04:38.800 He run them all up. 0:04:38.880 --> 0:04:41.640 So when I opened my practice, I almost had a 0:04:41.680 --> 0:04:46.120 full practice because of him. 0:04:46.320 --> 0:04:50.400 Maria brought a personalized touch to her Nacodocus practice because 0:04:50.440 --> 0:04:54.120 of her previous medical battle. Just after she was married, 0:04:54.480 --> 0:04:58.160 Maria had been diagnosed with thyroid cancer. She would fight 0:04:58.200 --> 0:05:03.320 through multiple surgeries to that cancer into remission. The experience 0:05:03.320 --> 0:05:07.200 allowed her to connect with her patients on a deeper level, 0:05:07.600 --> 0:05:10.720 but it was also the first sign of more serious 0:05:10.760 --> 0:05:12.000 medical issues to come. 0:05:14.800 --> 0:05:18.320 And I remember after the second surgery, you know, my throat, 0:05:18.360 --> 0:05:20.720 we just felt like I was being choked. I think 0:05:20.800 --> 0:05:24.320 that's when I started noticing something was going on, because 0:05:24.320 --> 0:05:27.839 then my voice changed. Every time I'd dictate or I 0:05:27.920 --> 0:05:30.720 taught to patients a lot, I would lose my voice. 0:05:30.760 --> 0:05:33.160 Would get very rasped. It would get very very very 0:05:33.279 --> 0:05:36.640 tight in my throat, and I could no longer sing. 0:05:36.680 --> 0:05:38.320 I mean, I was never the best saying I used 0:05:38.360 --> 0:05:40.560 to be in the choir. And again at that time, 0:05:40.640 --> 0:05:43.479 still thought that it was the thyroid that I'd had surgery, 0:05:43.600 --> 0:05:46.800 and so really wasn't you know, paying attention to the 0:05:46.880 --> 0:05:52.080 other things Prior to that and residency, I had noticed 0:05:52.120 --> 0:05:54.760 that I was getting a lot of tightness in my arm, 0:05:54.640 --> 0:05:55.440 in my right hand. 0:05:55.480 --> 0:05:58.760 I'm right handed. And again, you're busy. 0:05:58.960 --> 0:06:02.920 You just started learning about a new field, and everybody said, oh, 0:06:03.000 --> 0:06:04.360 you probably had carpal tunnel. 0:06:04.920 --> 0:06:09.200 Maria's symptoms started to become more substantial and noticeable just 0:06:09.240 --> 0:06:12.800 as she was navigating her new practice in Nacadocus, But 0:06:13.080 --> 0:06:17.159 as a young doctor under considerable stress, she pushed aside 0:06:17.160 --> 0:06:22.400 her own concerns to focus on those of her patients. 0:06:22.440 --> 0:06:26.720 When you were in a doctor role with Mark and 0:06:26.760 --> 0:06:31.000 you said that he and Janet became like family, was 0:06:31.160 --> 0:06:34.599 it reassuring or did that put pressure on you to 0:06:34.960 --> 0:06:37.280 serve in the capacity of being his neurologist. 0:06:38.040 --> 0:06:38.880 No, it was. 0:06:38.880 --> 0:06:41.919 Really nice to have that personal connection because you know, 0:06:42.440 --> 0:06:44.480 the one thing I'm sure you know, when you go 0:06:44.560 --> 0:06:46.440 to the doctor, you have a limited amount of time 0:06:46.480 --> 0:06:48.719 and then you focus on one thing or two things, 0:06:48.760 --> 0:06:49.839 and then you know, move up. 0:06:49.880 --> 0:06:51.679 But says I knew him. 0:06:52.040 --> 0:06:55.200 I could see from the outside things that were changing, 0:06:55.400 --> 0:06:57.680 things that were you know, bothering that he would not 0:06:57.800 --> 0:07:00.520 mention or his wife would not mention. I think I've 0:07:00.560 --> 0:07:04.200 always been a very personal, you know, be hispatic, maybe 0:07:04.240 --> 0:07:06.719 you know, touchy feely. I like to get everybody house 0:07:06.800 --> 0:07:09.760 and kisses, and you know, really get involved in their. 0:07:09.600 --> 0:07:12.000 Lives, like how's your family, are your kids? You know 0:07:12.160 --> 0:07:15.160 what's going on? And I think that makes a difference. 0:07:15.680 --> 0:07:20.320 Having formed such meaningful relationships with your patients. Was it 0:07:20.440 --> 0:07:23.880 difficult to watch Parkinson's take its toll on Mark? 0:07:24.320 --> 0:07:27.280 It was difficult because you know, as a loving friend, 0:07:27.800 --> 0:07:30.920 you know, I would tell Jennifer's heavy, noticed that his 0:07:31.200 --> 0:07:34.920 cognitive status is not as well he's repeating, or that 0:07:35.040 --> 0:07:37.680 he's been falling lots lately, and he doesn't tell me. 0:07:37.720 --> 0:07:43.280 There you see a very healthy, active person become less 0:07:43.280 --> 0:07:46.560 and less active. Does the tremors get worse? You know, 0:07:46.600 --> 0:07:49.880 it's hard to eat. As Mark said, you know, part 0:07:49.880 --> 0:07:53.440 of this stuff is you couldn't put corner peas on 0:07:53.480 --> 0:07:55.360 a fork because they're going to fly off. 0:07:56.200 --> 0:07:59.480 And I imagine that Maria was a huge support for 0:07:59.560 --> 0:08:02.360 you when your husband Mark passed. 0:08:02.880 --> 0:08:07.400 Oh yes, yes, yes, today he had his aneurysm. You know, 0:08:07.440 --> 0:08:10.000 it was just we knew and she, you know, she 0:08:10.080 --> 0:08:13.160 came up to the hospital because my daughter was traveling 0:08:13.880 --> 0:08:17.560 doing a spring break vacation with their two sons, and 0:08:17.600 --> 0:08:20.160 I called her and I said, you know, your dad's fallen. 0:08:20.280 --> 0:08:23.720 You need to come. And she drove the fifteen hours 0:08:23.760 --> 0:08:28.200 from Colorado back Toncadoches and Maria stayed with me till 0:08:28.240 --> 0:08:28.840 they got here. 0:08:31.120 --> 0:08:35.079 In terms of being such a hands on doctor, losing 0:08:35.160 --> 0:08:39.800 patients must never ugh, you don't get used to it. 0:08:40.040 --> 0:08:42.600 At least I never did. I mean, some people may 0:08:42.679 --> 0:08:45.079 develop some you know, you get a little bit tougher. 0:08:45.640 --> 0:08:51.160 But it always affected me, maybe because I always invested 0:08:51.240 --> 0:08:54.160 myself so much into people's lives and so it always 0:08:54.240 --> 0:08:54.679 was hard. 0:08:56.360 --> 0:08:59.640 As a neurologist, Maria had become well versed in the 0:09:00.160 --> 0:09:04.360 stating impact that a degenerative disease like Parkinson's can have 0:09:04.440 --> 0:09:08.400 on a patient's lifestyle and physical capabilities. While it was 0:09:08.480 --> 0:09:11.160 part of her role as a doctor, it never became 0:09:11.280 --> 0:09:15.640 less painful to process that inevitable decline. It became even 0:09:15.679 --> 0:09:19.200 more personal when her grandmother was diagnosed with the disease 0:09:20.120 --> 0:09:22.840 and just explained to me her walking through the door, 0:09:22.960 --> 0:09:24.720 what you picked up on and what you knew. 0:09:25.280 --> 0:09:28.439 Well, the first thing was that my uncle would say, well, 0:09:28.520 --> 0:09:29.960 she just doesn't want to do anything. 0:09:30.080 --> 0:09:31.120 She doesn't want to get up and go. 0:09:31.200 --> 0:09:33.800 She's very slow, and you know, of course all those terms, 0:09:33.840 --> 0:09:36.839 you know, thinking about Parkinson's. But all I had to 0:09:36.920 --> 0:09:38.520 do was take one look. She couldn't get out of 0:09:38.520 --> 0:09:41.280 the car to begin with, and her facial expression, her 0:09:41.400 --> 0:09:44.839 slowness and doing everything her caremors had gone work, and 0:09:44.960 --> 0:09:48.120 so it was very you know, obvious that this is 0:09:48.280 --> 0:09:51.360 what was going on. So I was, you know, a 0:09:51.480 --> 0:09:55.680 caregiver from Afar for that time until my grandfather passed 0:09:55.720 --> 0:09:58.760 away and she couldn't really walk and. 0:09:58.720 --> 0:10:02.360 Get around and shout stuff. I said, you can't be here. 0:10:02.400 --> 0:10:04.720 You don't have you know, the doctors here, you don't 0:10:04.760 --> 0:10:07.640 have you know, the medications. Nobody you know really gonna 0:10:07.880 --> 0:10:09.240 be able to take care of you. So on, don't 0:10:09.280 --> 0:10:12.240 you come back to Texas and we take care. 0:10:12.120 --> 0:10:13.680 Of you for you? 0:10:13.760 --> 0:10:17.600 That must have been surreal on so many levels. One, 0:10:17.760 --> 0:10:20.720 you know, you're wearing your doctor hat, your granddaughter hat, 0:10:20.800 --> 0:10:25.320 your caregiver hat, but also just the aspect that your 0:10:25.360 --> 0:10:30.800 grandmother has been diagnosed now and suffering with your area of. 0:10:30.760 --> 0:10:36.080 Expertise exactly exactly, And so that was really hard to see. 0:10:36.559 --> 0:10:39.319 And I thought, I'll get her into shape. You know, 0:10:39.640 --> 0:10:42.920 she'll come over here, We'll get her the right medications. 0:10:42.960 --> 0:10:45.440 I got her physical therapy, I got it, home health, 0:10:45.600 --> 0:10:46.280 got her everything. 0:10:48.880 --> 0:10:51.960 Sadly, with time, the degenerative disease would still go on 0:10:52.040 --> 0:10:55.120 to take her grandmother's life. Maria had now lost two 0:10:55.240 --> 0:10:59.360 loved ones, her grandmother and her friend Mark Janet's husband, 0:10:59.679 --> 0:11:03.960 to this same disease. She dedicated her life to studying Parkinson's, 0:11:04.360 --> 0:11:07.240 but even as she continued to prioritize caring for her 0:11:07.280 --> 0:11:10.960 patients and family, it was becoming harder and harder to 0:11:11.000 --> 0:11:16.560 ignore her own progressing symptoms. When did you start to 0:11:16.640 --> 0:11:19.400 realize that something was really off. 0:11:20.040 --> 0:11:24.000 When it really happened was right before my grandmother passed away. 0:11:24.240 --> 0:11:28.439 That's when things got really worrisome, that something was. 0:11:28.640 --> 0:11:29.720 It really dawned on me. 0:11:30.000 --> 0:11:32.679 I got something, and this is serious. I mean I 0:11:32.760 --> 0:11:34.599 was going to bathroom a million times a day. I 0:11:34.679 --> 0:11:36.640 was going to bathroom all the time. And you know, 0:11:36.679 --> 0:11:39.040 I went to the doctor and they're like, you don't 0:11:39.080 --> 0:11:41.400 have you know, it's fine, it's fine, And I'm like, well, 0:11:41.559 --> 0:11:45.200 I can't drive, you know, like a mile without stopping. 0:11:45.240 --> 0:11:45.480 You know. 0:11:46.000 --> 0:11:50.360 Also I was starting to have visual defects. One and night, 0:11:50.760 --> 0:11:53.760 I couldn't judge distance, so I almost got run over 0:11:53.760 --> 0:11:56.440 a couple of times. I would notice that that constant 0:11:56.480 --> 0:11:59.280 stopping and starting, you know, the gas pedal. 0:11:59.679 --> 0:12:03.000 It cramped my legs so bad that I. 0:12:03.000 --> 0:12:04.880 Was really worried that I would to get into access 0:12:04.880 --> 0:12:08.320 because it would get so involuntility contracted that I couldn't 0:12:08.320 --> 0:12:10.640 release it. And if I suddenly pressed on the gas 0:12:10.720 --> 0:12:14.480 or something, I was going to you know, have problems. 0:12:15.040 --> 0:12:17.800 As all these other symptoms were going on, some of 0:12:17.840 --> 0:12:20.480 the thyroid dishes were coming back, and so I had 0:12:20.559 --> 0:12:23.360 recurrence of the cancer you know, and had to then 0:12:23.480 --> 0:12:26.520 go through the eyedine treatment and things, which is then 0:12:26.600 --> 0:12:28.400 worse than my other symptoms. 0:12:28.440 --> 0:12:29.720 So it's like it's a lot. 0:12:31.000 --> 0:12:34.200 But even when Maria, as a young doctor and young mother, 0:12:34.640 --> 0:12:38.280 turned to other doctors for help, she found they dismissed 0:12:38.280 --> 0:12:43.080 her downplay her symptoms, something her friend Janet recalls, Well, 0:12:43.120 --> 0:12:46.679 you mentioned that she almost knew too much. Yes, in 0:12:46.720 --> 0:12:48.839 what ways do you think it was difficult for her 0:12:49.000 --> 0:12:52.280 being a doctor, dealing with these symptoms and going to 0:12:52.360 --> 0:12:55.600 other doctors and kind of being told it was in 0:12:55.640 --> 0:12:56.280 her head. 0:12:56.760 --> 0:12:59.800 Very very frustrating, because you know, she knew something was 0:12:59.800 --> 0:13:01.960 good going on. I think that's probably one of the 0:13:02.040 --> 0:13:05.800 first reasons that she went back to the doctor for 0:13:05.880 --> 0:13:09.320 the thyroid cancer, just to kind of see maybe if 0:13:09.400 --> 0:13:13.200 that was causing the problem, because it was basically a 0:13:14.160 --> 0:13:18.120 you know, let's see this symptom, let's treat that you 0:13:18.160 --> 0:13:19.840 had to rule out all these other things. 0:13:20.920 --> 0:13:25.160 Maria's morphing symptoms were gradually eroding her ability to maintain 0:13:25.280 --> 0:13:30.439 the patient centered medical practice she'd painstakingly built, and making 0:13:30.520 --> 0:13:33.920 day to day life more difficult. Support for her symptoms 0:13:34.160 --> 0:13:37.199 was on the horizon, but not before her life as 0:13:37.240 --> 0:13:39.400 she knew it would be fully upended. 0:13:40.000 --> 0:13:44.080 I started not seeing that I could not really tell 0:13:44.679 --> 0:13:48.200 what was going on on my left dreshold vision. I 0:13:48.320 --> 0:13:51.319 was having a hard time parking between two cars. 0:13:52.160 --> 0:13:55.680 Everybody was saying, your eyes are fine, your vision is fine. 0:13:55.960 --> 0:13:58.040 How can it be fine? I cannot draw? 0:14:00.160 --> 0:14:11.080 Be right back with Symptomatic, a Medical Mystery Podcast. Now 0:14:11.120 --> 0:14:18.920 back to Symptomatic a Medical Mystery Podcast. Doctor Maria de 0:14:19.040 --> 0:14:23.320 Leone had supported so many patients through challenging diagnostic journeys. 0:14:23.840 --> 0:14:27.080 Now she was navigating one of her own. She'd been 0:14:27.120 --> 0:14:32.520 experiencing involuntary muscle contractions and tightness for years, but now 0:14:32.560 --> 0:14:37.240 her vision was being negatively impacted too. The cumulative symptoms 0:14:37.280 --> 0:14:43.280 were weighing heavily on her professional and personal life. 0:14:44.440 --> 0:14:47.200 I started noticing when you do the exam with the patients, 0:14:47.480 --> 0:14:49.840 you know, fingertab open and closed, And I was like, wait, 0:14:49.880 --> 0:14:50.520 what the heck. 0:14:50.400 --> 0:14:52.160 Can I do that? You know, so that I'm looking 0:14:52.160 --> 0:14:54.360 at myself like I'm having trouble doing that. 0:14:55.080 --> 0:14:58.600 Going back to your earliest memories of seeing those issues, 0:14:58.840 --> 0:15:00.280 what did you notice. 0:15:01.240 --> 0:15:04.400 As her being our doctor? You know, I got to 0:15:04.480 --> 0:15:07.440 watch the seven eight years she was in practice. I 0:15:07.480 --> 0:15:13.120 watched her handwriting go from semi legible to totally illegible, and 0:15:13.400 --> 0:15:16.280 just you know, watching her personality change a little bit. 0:15:16.320 --> 0:15:21.320 Because when you're you don't feel good, everything starts magnifying. 0:15:22.520 --> 0:15:24.280 And so I wasn't sure if I was irritable because 0:15:24.320 --> 0:15:26.200 all these things going on, Alli is zerrable. But I 0:15:26.280 --> 0:15:28.000 was irritable all the time, like I said, And my 0:15:28.040 --> 0:15:30.520 patients were like, you're being smaller today, you know, you 0:15:30.560 --> 0:15:32.760 didn't give us a hurt getting I'm like, I just 0:15:32.800 --> 0:15:33.880 want to get out of here, you. 0:15:33.800 --> 0:15:36.040 Know, it's like I don't want to be with anybody. 0:15:36.200 --> 0:15:39.480 But looking back, how are things progressing for you? 0:15:39.480 --> 0:15:39.680 You know? 0:15:39.840 --> 0:15:41.760 Like I always did my nails. 0:15:41.800 --> 0:15:44.440 I always had you know, flash and Esta completely always 0:15:44.480 --> 0:15:47.240 had you know, to the tee, the shoes, the hair, 0:15:47.360 --> 0:15:50.520 the earrings and everything, and well, I try to do 0:15:50.640 --> 0:15:53.720 my nails and it was like a three year old 0:15:53.760 --> 0:15:54.320 doing them. 0:15:54.400 --> 0:15:58.440 It's like they were just mets. It's like, what the heck? 0:15:59.000 --> 0:16:00.520 And I was hurting all the time. 0:16:00.920 --> 0:16:02.400 How would you describe that pain? 0:16:03.080 --> 0:16:08.920 The pain was so excruciating that I could not stand 0:16:09.120 --> 0:16:12.960 anyone to touch me because it felt like fire. I 0:16:13.000 --> 0:16:16.120 could not shower because the water dripping on me, touching 0:16:16.200 --> 0:16:19.720 my skin feel like acid was pouring down. So that's 0:16:19.760 --> 0:16:22.600 how severe I got to the point I was in 0:16:22.720 --> 0:16:25.560 tears all the time, couldn't touch my daughter. I was like, no, 0:16:25.800 --> 0:16:28.080 I mean, it was hard to deal with that. 0:16:30.360 --> 0:16:32.440 What did they think was going on with you. Did 0:16:32.480 --> 0:16:35.520 they think that you were appropriating the symptoms you were treating. 0:16:35.920 --> 0:16:39.280 They told me go see a psychiatrists and really hurt 0:16:39.320 --> 0:16:42.200 me at the time. It really made me realize, these 0:16:42.240 --> 0:16:45.320 are the same people that trusted me with their patients. 0:16:45.560 --> 0:16:49.080 They're questioning my own capability of dinas and myself saying 0:16:49.080 --> 0:16:51.720 that there's something wrong with me. And they're saying, oh, 0:16:51.880 --> 0:16:54.040 you just you know, depressed, you just need to go 0:16:54.160 --> 0:16:56.720 back to work. You've just been through a line. And 0:16:56.760 --> 0:16:58.600 I was like, how can that be? How can they, 0:16:58.680 --> 0:17:01.520 under one hand trust me and at the same time 0:17:01.600 --> 0:17:03.720 said that they'd think, I'm, you know, just making all 0:17:03.720 --> 0:17:04.480 these stags up. 0:17:05.200 --> 0:17:08.800 So at this point, Maria's symptoms are starting to become 0:17:08.880 --> 0:17:14.119 more obvious and she's actively seeking a diagnosis. Do you 0:17:14.200 --> 0:17:19.440 remember how she was feeling during this time, overwhelmed, frustrated. 0:17:20.160 --> 0:17:23.520 Yes, when she especially when she came home, and that's 0:17:23.560 --> 0:17:26.080 what they told her, she would just you know, vent 0:17:26.680 --> 0:17:29.400 and go you know, it's not like this, we're in tears. 0:17:30.359 --> 0:17:33.240 I know something's going on. I'm sure it's the same 0:17:33.240 --> 0:17:36.240 thing that doctors go through when they have these difficult 0:17:36.320 --> 0:17:38.520 to diagnose patients. 0:17:38.640 --> 0:17:42.159 So after three years of having every test done, seeing 0:17:42.280 --> 0:17:48.600 every single specialist, basically under the sun, having every test 0:17:48.800 --> 0:17:52.600 short of a brain biopsy. I was ritnette. I was exhausted. 0:17:52.640 --> 0:17:54.679 I had had done my hours at work. I was 0:17:54.720 --> 0:17:58.280 no longer taking call. I couldn't sleep, I was falling 0:17:58.359 --> 0:17:58.639 by that. 0:17:59.320 --> 0:18:02.320 Pushed to her brain point, Maria reached out to the 0:18:02.359 --> 0:18:05.960 one person she knew would take the time to piece 0:18:06.000 --> 0:18:10.040 together the many complicated parts of her mysterious medical challenges, 0:18:10.640 --> 0:18:15.399 doctor Maya, She, whom Maria had first met while in residency. 0:18:15.880 --> 0:18:19.560 I finally called Maya and I said, Maya, I've been 0:18:19.560 --> 0:18:23.520 dealing with this. I'm exhausted. I don't know what to do. 0:18:23.920 --> 0:18:27.080 I know there's something wrong with me. I know it's neurological. 0:18:27.359 --> 0:18:30.800 I think is Parkinson's, but I don't know. Got these 0:18:30.840 --> 0:18:33.800 other symptoms that don't fit into the picture. But you know, 0:18:34.040 --> 0:18:36.919 I need your opinion. I said, if you think that 0:18:37.040 --> 0:18:40.200 it's all psychological, and I've been through so much stress 0:18:40.280 --> 0:18:43.760 and grievings and whatever, I said, I'll take their opinion. 0:18:43.840 --> 0:18:47.679 I'll get help, Okay. 0:18:47.840 --> 0:18:51.920 First name is Maya, last name is She. I'm a 0:18:51.960 --> 0:18:55.439 tenured professor at the University of Texas. Health Science Center. 0:18:56.040 --> 0:18:59.360 I'm in the department of Neurology. I'm actually the director 0:18:59.560 --> 0:19:05.280 of our Movement Disorders and Neudegenerative Diseases Clinic and Fellowship 0:19:05.359 --> 0:19:10.280 program director. I realized that in my lifetime I would 0:19:10.280 --> 0:19:14.080 never fully understand the brain or the nervous system, and 0:19:14.119 --> 0:19:18.399 so that became an attraction for me to always be challenged. 0:19:19.359 --> 0:19:23.359 I would think that that makes you and Maria very 0:19:23.440 --> 0:19:24.840 much cut from the same cloth. 0:19:25.280 --> 0:19:29.000 Yes, yes, we are cut from the same cloth. We 0:19:29.040 --> 0:19:34.440 talked about this difficulty she was sensing in her her movements, 0:19:34.720 --> 0:19:39.080 and my interpretation of them were that she had change 0:19:39.119 --> 0:19:39.720 in her gait. 0:19:40.320 --> 0:19:42.320 So my first thoughts. 0:19:42.000 --> 0:19:45.840 About her was that she actually had what's called DOPA 0:19:45.960 --> 0:19:49.520 response of dystonia. In fact, my first notes, I was 0:19:49.640 --> 0:19:52.720 noting this change in rigid tone. I mean she was 0:19:52.800 --> 0:19:56.399 like thirty five thirty seven, she was young, and I 0:19:56.480 --> 0:19:59.760 was noticing that she had a symmetry in her limbs. 0:20:00.119 --> 0:20:03.879 She had especially some increased tone in her leg and 0:20:04.280 --> 0:20:07.920 armed on one side. And she was telling me that 0:20:07.960 --> 0:20:12.960 sometimes she had difficulty holding objects and she felt that 0:20:13.000 --> 0:20:16.920 her gait had changed. So that's what I picked up initially. 0:20:18.720 --> 0:20:23.520 Having fully examined Maria's symptoms and concerns doctor She's initially 0:20:23.560 --> 0:20:27.440 prescribed a dopamine agent for an enzyme deficiency. She then 0:20:27.520 --> 0:20:31.920 focused on Maria's spinal imagery due to her asymmetrical reflexes. 0:20:33.000 --> 0:20:36.360 So the moment of truth is when I saw how 0:20:36.520 --> 0:20:42.480 robustly she responded to dolopminergic medicine replacement of dopamine. 0:20:43.320 --> 0:20:45.679 You knew that she had been to a number of 0:20:45.720 --> 0:20:50.480 doctors over a number of years knowing her. Why was 0:20:50.520 --> 0:20:53.280 she so frustrated and why was she desperate by the 0:20:53.280 --> 0:20:54.119 time she came to you. 0:20:54.600 --> 0:20:58.440 So I think she was really frustrated because number one, 0:20:58.680 --> 0:21:01.480 people are afraid of doctor. They're afraid of taking care 0:21:01.520 --> 0:21:04.920 of them doctors. It's true, we make terrible patience. 0:21:06.200 --> 0:21:08.280 We don't do what we're told. 0:21:09.119 --> 0:21:13.320 We overthink, you know. So I think people were intimidated. 0:21:14.119 --> 0:21:15.880 She's a really good doctor. 0:21:16.560 --> 0:21:19.720 But that's not fair to her because she still deserves 0:21:20.240 --> 0:21:23.119 a good exam, a good understanding of what's going on. 0:21:24.000 --> 0:21:28.760 Right After three years of juggling symptoms and searching for answers, 0:21:29.160 --> 0:21:32.240 Maria finally had a doctor who saw her full symptomatic 0:21:32.320 --> 0:21:35.480 picture and led her to a diagnosis. She was all 0:21:35.520 --> 0:21:41.440 too familiar with Parkinson's disease being diagnosed by Maya. What 0:21:41.560 --> 0:21:45.040 was that like for you? Did you feel vindicated on 0:21:45.080 --> 0:21:47.600 some level and terrified on others? 0:21:48.400 --> 0:21:51.720 I was initially very vindicated and happy when she said 0:21:51.720 --> 0:21:54.840 you have Parkinson's. I was like, yeah, looks like, you know, 0:21:55.000 --> 0:21:58.400 like a celebration until it, you know, settled a few 0:21:58.480 --> 0:21:59.040 days later. 0:21:59.080 --> 0:22:01.680 But at first of it was I knew it's not crazy. 0:22:02.080 --> 0:22:03.879 I knew that I had something going on. 0:22:06.600 --> 0:22:09.199 I know that when she was kind of diagnosed with 0:22:09.320 --> 0:22:12.919 that and actually got on some of the Parkinson's mids, 0:22:13.600 --> 0:22:18.360 her muscle softened just you know, like an immediate relief that, 0:22:18.520 --> 0:22:20.320 you know, things were doing better. 0:22:21.600 --> 0:22:25.200 When I started the medicine, even the small amounts initially, 0:22:25.280 --> 0:22:28.120 until we you know, got the can doses right and everything. 0:22:28.760 --> 0:22:32.640 I noticed that, hey, my vision is some better and 0:22:33.040 --> 0:22:35.639 my pain is some better. And again it's like, if 0:22:35.680 --> 0:22:38.199 I'm having this much trouble and I am a physician 0:22:38.359 --> 0:22:42.000 that specializes in this disease and it took me three 0:22:42.080 --> 0:22:45.640 years to get an official diagnosis from somebody and get treated, now, 0:22:45.720 --> 0:22:49.560 imagine what all these people around the world I do 0:22:49.640 --> 0:22:52.840 it and feeling and dealing with and in reality most 0:22:52.840 --> 0:22:55.160 women take about three to five years to get diagnosed, 0:22:55.760 --> 0:22:56.760 especially when they're younger. 0:22:58.080 --> 0:23:01.720 That's Maria's personality, and I'm not sure even reflecting on 0:23:01.760 --> 0:23:05.080 the life changing news that she'd been seeking, she sympathizes 0:23:05.119 --> 0:23:08.040 with people who don't have the same advantages she had 0:23:08.320 --> 0:23:10.560