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To Beat Parkinson’s, You Must Stand on Your Head

By WOJCIECH WASILEWSKI

Dear Reader, if you’re looking for something soft and easy, please buy a different book. This one isn’t here to comfort you — it’s here to shake your lazy world, to shock you, to drag you out of the same lethargy I was trapped in for years after being diagnosed. If you feel anger, rebellion, or even a surge of motivation while reading, then it was worth writing this book, each and every hour. Parkinson’s isn’t polite — and I won’t be either. This is my war manifesto against Parkinson’s.

Throughout this book, I use the word “Parkinson” as shorthand for Parkinson’s disease, not as a reference to James Parkinson, the doctor who first described it. If that feels like an oversimplification — I apologize. But trust me, it’s the least important thing here.

People today are searching for real stories — not textbook definitions, sterile medical jargon, or sugar-coated tales of suffering. You won’t find any of that here. What you’ll find instead is something far more valuable: the truth. Raw, unfiltered, sometimes brutal, sometimes even vulgar. Why? Because that’s what this disease really is. That’s the kind of relentless fight you’ll need if you don’t want Parkinson’s to steal your life, piece by piece. I’m not afraid of that fight — and this is exactly what this book is about. I want you to stop being afraid and to believe you can get into this fight too.

This is not a scientific book. I’m not a doctor. I don’t have a PhD. I’m not an “expert” who appears on morning TV. I’m just a patient — like you. Someone who heard the diagnosis and, instead of quietly accepting it and waiting for the end, chose to fight back. And the most important part? After years of struggle, I’m living proof that it can be done. This isn’t theory — it’s my sweat, my pain, my setbacks, and my comebacks. If you want to read the story of someone who curses Parkinson’s out loud every day and refuses to let it win — you’re in the right place.

If you want to hear the voice of someone who tests every possible method to claw back one more day of normal life from this disease, someone who isn’t afraid to speak the truth and take risks — this book is for you. This is my declaration of war on Parkinson’s. And if you’re ready to join me in this fight — come on board. Because to live well with Parkinson’s, you have to completely change your lifestyle. That’s exactly what this book is about.

PARKINSON’S AFFECTS THE YOUNG

I’m talking to you — the person who typed into Google: “Parkinson’s and physical activity,” “diet and Parkinson’s,” “how to stop Parkinson’s,” “can you recover from Parkinson’s,” or “can young people get Parkinson’s.” If you’ve landed here, you’re searching for answers. I’m no miracle worker. I don’t have magic pills or secret formulas. I do have something better though — real strategies that work for me. Not just for me.

This isn’t an academic thesis. This is a battle guide. A survival manual. It’s about resisting this disease, outsmarting it, slowing it down, exhausting it. It’s about clawing back one more day of normal life — and doing it all over again tomorrow.

You know what annoys me the most? That the majority of people still think Parkinson’s is a disease of old men sitting on benches outside their apartment buildings. That’s just not true. More and more young people — people who should have their whole lives ahead of them — are being diagnosed. And then what? Fear. Panic. The crushing feeling that everything is over. Doctors rarely have time to explain what’s really going on. And the internet? It hits you with nightmare scenarios — videos of people shaking so violently they can’t even lift a spoon. Nevertheless, that’s not the full truth about Parkinson’s.

For younger people, Parkinson’s is a completely different fight — a different tempo, a different pressure, a different kind of war. They are the ones who this book is for. For people in their 30s, 40s, and 50s, with families, careers, dreams, and plans — all of which Parkinson’s is trying to rip away. We don’t have to let it happen. We can fight back.

WORDS OF CRITICISM FOR THE CRITICS

I can already hear the noise — the mocking, the scoffing, the eye-rolling. Critics saying there’s no scientific proof, that maybe something did work for me but won’t work for anyone else, that it’s all clichés and empty words. Maybe my Parkinson’s is ‘defective,’ they’ll say. Or maybe I don’t even have it. Or I just got lucky and ended up with the soft version — you know, Parkinson’s Lite.

To all the critics who will claim that nothing in this book works, I have only one thing to say: Keep on clucking.

When I first decided to fight Parkinson’s, my condition was declining fast. I had muscle rigidity. I could barely walk. My left arm didn’t swing. I felt that heavy-leg fatigue, and my tremors were intense. I passed out twice — both times collapsing in the bathroom. Then I underwent the FUS procedure, and it significantly reduced the tremor in my left hand. That was the moment I realized I had to change my life. And so began a slow but powerful transformation.

I HAVEN’T WON THE WAR

Let’s be clear, dear Reader: I haven’t won the war against Parkinson’s — not even close. Writing this book, after working full-time as an analyst for eight hours a day, takes a toll on me. Sitting at the computer for hours temporarily worsens my symptoms. Just this morning, I woke up in pain — arms, legs, back, everything.

And what did I do? First I went for a light three-kilometer run. Next I took a freezing cold shower. Then I had a healthy breakfast. These simple steps and just like that — my body came back to life.

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Residency and Parenting Are Incompatible

By EMILY JOHNSON 

Being a parent during residency requires one or more of the following:

●     Family and/or friends nearby who are willing and able to provide free childcare

●     A stay-at-home spouse/co-parent

●     A spouse/co-parent who is willing to let their own career to be a distant second priority beneath family responsibilities and the resident’s career

●     Significant amounts of generational wealth that allow you to outsource household and childcare obligations with money you didn’t personally earn

●     High levels of financial risk tolerance and willingness to incur extraordinary levels of debt above and beyond average medical school debt ($234k!). 

Because medical residency in the United States is incompatible with being a parent.

It is a Sunday evening, and I am writing this as I wait for my husband to get back from the hospital. He was “on call” today, which, in lay terms means his work hours were “all day.” He was out the door before I woke up, and it is now 9:30pm and Find My shows that he is still at the hospital. So that means he’s on hour 15 or 16 of his workday, and he could be leaving in a few minutes, or he could be there for another few hours (and I have no idea which).

I do know he got at least a 15-minute break today, because our toddler and I went to the hospital today to have lunch with him. Why interrupt his workday, drag a toddler across town right before nap time (thereby risking the loss of my cherished mid-day downtime because of the dreaded car nap), and pay for parking and mediocre cafeteria food on a Sunday? Because if I hadn’t, I truly don’t know when my son would have seen his dad next.

This pattern – out before the family wakes up, back after bedtime- is the rule, not the exception. An “early” day might mean he gets out before 7pm – but that doesn’t guarantee that he’ll see our toddler, who goes to bed between 7 and 7:30pm.  

As a medical spouse with a young child, of the most infuriating comments I ever hear is among the lines of “but don’t they cap work hours now?” Or even worse – the occasional insinuation that perhaps today’s residents have it “too easy” because of work hour restrictions. Because the answer is yes – work hours are technically capped at 80 hours/week – but let’s talk about that: 

First, here’s what an 80 hour/week schedule looks like, in case you haven’t worked one lately:

 MonTuesWedsThursFridaySatSun
Start6:45am6:45am6:45am6:45amOFF(but studying for upcoming board exam)6:45am6:45am
End8pm6pm5:30pm8pm8pm10pm
Total Hours13+111113+13+16 (and counting)
Total: 77 + study time (Bingo! No problems here! Under 80 hours/week)

Second, from a caregiving perspective, an 80/hour week cap is laughable, because you can still miss 100% of a toddler’s waking hours most days of the week on an 80 hour/week schedule.

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Feeling the Pressure

By MIKE MAGEE

After Trump crashed the markets, citizens worldwide are “feeling the pressure.” But in the spirit of calming us down, let’s consider a story of human cooperation and success from our past.

It has been estimated that a medical student learns approximately 15,000 new words during the four years of training. One of those words is sphygmomanometer. the fancy term for a blood pressure monitor. The word is derived from the  Greek σφυγμός sphygmos “pulse”, plus the scientific term manometer (from French manomètre).

While medical students are quick to memorize and learn to use the words and tools that are part of their trade, few fully appreciate the centuries-long efforts to advance incremental insights, discoveries, and engineering feats that go into these discoveries.

Most students are familiar with the name William Harvey. Without modern tools, he deduced from inference rather than direct observation that blood was pumped by a four chamber heart through a “double circulation system” directed first to the lungs and back via a “closed system” and then out again to the brain and bodily organs. In 1628, he published all of the above in an epic volume, De Motu Cordis. 

Far fewer know much about Stephen Hales, who in 1733, at the age of 56, is credited with discovering the concept of “blood pressure.” A century later, the German physiologist, Johannes Müller,  boldly proclaimed that Hales “discovery of the blood pressure was more important than the (Harvey) discovery of blood.” 

Modern day cardiologists seem to agree.

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Emory, Balloon Angioplasty, and the Musk Attack on Medical Diplomacy

By MIKE MAGEE

 “The recently announced limitation from the NIH on grants is an example that will significantly reduce essential funding for research at Emory.”       

                                              Gregory L. Fenes, President, Emory University 

In 1900, the U.S. life expectancy was 47 years. Between maternal deaths in child birth and infectious disease, it is no wonder that cardiovascular disease (barely understood at the time) was an afterthought. But by 1930, as life expectancy approached 60 years, Americans stood up and took notice. They were dropping dead on softball fields of heart attacks. 

Remarkably, despite scientific advances, nearly 1 million Americans ( 931,578) died of heart disease in 2024. That is 28% of the 3,279,857 deaths last year. 

The main cause of a heart attack, as every high school student knows today, is blockage of one or more of the three main coronary arteries – each 5 to 10 centimeters long and four millimeters wide. But at the turn of the century, experts didn’t have a clue. When James Herrick first suggested blockage of the coronaries as a cause of heart seizures in 1912, the suggestion was met with disbelief. Seven years later, in 1919, the clinical findings for “myocardial infarction” were associated with ECG abnormalities for the first time. 

Scientists for some time had been aware of the anatomy of the human heart, but it wasn’t until 1929 that they actually were able to see it in action. That was when a 24-year old German medical intern in training named Werner Forssmann came up with the idea of threading a ureteral catheter through a vein in the arm into his heart. 

His superiors refused permission for the experiment. But with junior accomplices, including an enamored nurse, and a radiologist in training, he secretly catheterized his own heart and injected dye revealing for the first time a live 4-chamber heart. Two decades would pass before Werner Forssmann’s “reckless action” was rewarded with the 1956 Nobel Prize in Medicine. But another two years would pass before the dynamic Mason Sones, Cleveland Clinic’s director of cardiovascular disease, successfully (if inadvertently) imaged the coronary arteries themselves without inducing a heart attack in his 26-year old patient with rheumatic heart disease. 

But it was the American head of all Allied Forces in World War II, turned President of the United States, Dwight D.Eisenhower, who arguably had the greatest impact on the world focus on this “public enemy #1.” His seven heart attacks, in full public view, have been credited with increasing public awareness of the condition which finally claimed his life in1969. 

Cardiac catheterization soon became a relatively standard affair. Not surprisingly, less than a decade later, on September 16, 1977, an East German physician, Andreas Gruntzig performed the first ballon angioplasty, but not without a bit of drama. 

Dr. Gruntzig had moved to Zurich, Switzerland in pursuit of this new, non-invasive technique for opening blocked arteries. But first, he had to manufacture his own catheters. He tested them out on dogs in 1976, and excitedly shared his positive results in November that year at the 49th Scientific Session of the American Heart Association in Miami Beach. 

He returned to Zurich that year expecting swift approval to perform the procedure on a human candidate. But a year later, the Switzerland Board had still not given him a green light to use his newly improved double lumen catheter. Instead he had been invited by Dr. Richard Myler at the San Francisco Heart Institute to perform the first ever balloon coronary artery angioplasty on an awake patient.

Gruntzig arrived in May, 1977, with equipment in hand. He was able to successfully dilate the arteries of several anesthetized patients who were undergoing open heart coronary bypass surgery. But sadly, after two weeks on hold there, no appropriate candidates had emerged for a minimally invasive balloon angioplasty in a non-anesthetized heart attack patient. 

In the meantime, a 38-year-old insurance salesman, Adolf Bachmann, with severe coronary artery stenosis, angina, and ECG changes had surfaced in Zurich. With verbal assurances that he might proceed, Gruntzig returned again to Zurich. The landmark procedure at Zurich University Hospital went off without a hitch, and the rest is history. 

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Between Hope and Grief: A Medical Memoir of Father, Son, and Family

By GEORGE BEAUREGARD

This piece is different from the typical “health-care industry” topics covered in this forum. 

My Sunday morning routine usually involves getting a cup of coffee and downloading the most recent editions of magazines on my iPad.

The cover of the February 13 edition of Time magazine immediately caught my attention because the title read “OUR CANCER MYSTERY. WHY IT’S NOW STRIKING US SO YOUNG’’. Four people are on the cover: their names, cancer types, and age at diagnosis displayed. 18 to 40. I imagine that the majority of readers might describe their expressions as neutral and composed, their posture calm.

But I see what exists below the restrained surfaces. Something I am all too familiar with. Disbelief. Worry, Bewilderment. Uncertainty. Sadness.

Although overdue, a major news magazine had finally put it out there, front and center. A call to action.

On September 14, 2017, I was standing in a hospital room in Boston, when my previously healthy son, Patrick, then 29, received the shocking news that he probably had stage 4 colorectal cancer, which further tests confirmed. That grave diagnosis came with a bleak 14 percent relative 5-year survival rate. Like the cognitive simulation of Schrödinger’s cat, my beloved son’s life now lay in a sealed box, with a hammer hovering over a flask of toxin. Would it fall, smash the vial, and kill my son? I could only be an observer. I desperately wanted to be the one in the box instead of him.

Fatherhood and medicine are integral to my identity. Throughout the three years during which he received superb care at Dana Farber Cancer Institute,  in Boston, I had to be his father first, offering emotional support with love and hope. The physician adviser part was a secondary role.

Despite his indomitable spirit, positivity and best efforts, Patrick took his last breath on September 6, 2020, in his childhood home, Although relieved that his suffering was over, I was caught in immense sorrow, not yet realizing that eventually acceptance would slowly weave itself through the grief,  and I would gain a nuanced understanding of “before and after.’’

As I mentioned in my 12/6/2024 piece in this forum, I hadn’t thought very much about early-onset cancer during many of the  years that I was in clinical practice and as a physician executive.( I had categorized my experience with bladder cancer at 49 as an anomaly.) But that has changed in the past few years, during which the rising incidence of cancer in younger adults has been, first, in the scientific and medical literature and then sporadically in the broad national news, especially since the summer of 2023. But millions of people still have no idea that this is happening. 

Writing is how I express myself best, so in early 2020, I started writing to help myself navigate what was happening to Patrick. As the global phenomenon of early-onset cancers expanded, I felt compelled to tell my son’s inspirational story and raise awareness of early-onset cancer and  the need to dramatically expand screening for it. Over three years, I wrote a book titled RESERVATIONS for NINE: A DOCTOR’S FAMILY CONFRONTS CANCER, published earlier this month and timed to CRC Awareness Month. A labor of love and grief, it’s a book about family, love, loss, science and spirituality. Craig Melvin, NBC’s TODAY Show co-anchor, graciously wrote the foreword. Three months after my son passed away, Craig lost his 43-year-old brother to the same disease.

Many books have been written about cancer. From a patient undergoing treatment, to a family member or other caregiver, to a doctor treating a patient, to a researcher looking to change the trajectory of those being diagnosed and treated. But this one is unique. Part memoir and tribute, interspersed with journal entries by my son and others in my family. Part medical saga, the book aims to educate the public about the dangerous global rise in early-onset cancers, and  to help provide a roadmap by example of loved ones going through cancer battles, and a call to action to the medical community to get ahead of this crisis. 

My son’s life shouldn’t be defined by cancer, but, rather, how he responded to it. Most inspirational was how he became a strong public advocate of screening  and funding for cancer research.

I hope that readers of THCB can find the time to share the messages of this book with family, friends and colleagues.

Thank you, Matthew and THCB for providing this forum to present my story.

My website is https://www.georgebeauregard.com and you can buy the book there or on Amazon. My appearance on the Today show is here.

George Beauregard, DO is an Internal Medicine physician whose experience includes 20+ years of clinical practice as well as leading organizations strategic and clinical initiatives

Katherine Saunders, FlyteHealth

Katherine Saunders is the co-founder and CMO at FlyteHealth. She was one of the first 20 obesity fellows in the US. FlyteHealth is the specialized online obesity clinic that resulted from her desire to scale what works for individuals to combat their obesity–by the time people get to FlyteHealth 99% of them are ready for medical treatment. Katherine explains how FlyteHealth manages the whole of the patient’s experience with MDs, NPs, dieticians and more. Yes, we talked about GLP1s too!

Meanwhile if you want to know about the science of obesity, here’s Katherine’s TedTalk.

Cancer’s Juvenescence: An Incoming Tide and the Urgent Need for a Paradigm Shift

By GEORGE BEAUREGARD

During my years in a bustling metropolitan primary care practice from 1992 to 2010, I recall only a handful of patients under 50 who developed cancer. Not surprisingly, these were mostly cases of Hodgkin’s and Non-Hodgkin’s lymphomas, myeloma, skin, and breast cancer. Fortunately, those few patients were wearing the mantle of cancer survivor by the time I left clinical practice.

Since 2010, I’ve transitioned into physician executive roles across various U.S. markets, overseeing large physician networks and other health systems, including so-called Accountable Care Organizations (ACOs) that oversee the care of tens of thousands of attributed patients. My goal has been to help transform healthcare delivery to focus on consistently delivering high-value care–defined as being of high quality and cost effective. My engagement with cancer has mainly been through monitoring how our organization performs on established cancer screening measures for breast, colon, and cervical cancers, based on HEDIS guidelines for age ranges.

During those two periods, my life took two profound turns. The first occurred in October 2005 when I was diagnosed at 49 with advanced-stage bladder cancer. The second, more devastating one, occurred on September 16, 2017, when my previously healthy 29-year-old son was unexpectedly diagnosed with stage 4 colon cancer. That shocking news came a month after his wedding. While I knew the grim 5-year relative survival rate for this stage was about 13 percent, I still hoped and prayed that he would somehow end up being on the positive side of that survival statistic.

Throughout his three-year treatment at Dana Farber Cancer Institute (DFCI), in Boston, my son, while courageously fighting his battle—one he would eventually lose at 32—became a passionate advocate for raising early-onset colorectal cancer (CRC) awareness and the need for increased research funding. He played an important role in helping to launch DFCI’s Young Onset Colorectal Cancer Center, which has since treated over 1,500 patients. Many of those individuals are between the ages of 20 and 40. Six months before his death, my son made a memorable appearance on The Today Show.

Fatherhood and medicine are deeply ingrained in my identity. After the initial shock of my son’s diagnosis, I delved into medical and scientific literature, seeking all relevant information. What I’ve discovered, and continue to learn, is that there’s been a global surge in early-onset cancers, defined as occurring in people under the age of 50. Between 1990 and 2019, early-onset cancer cases globally surged by nearly 80 percent, with related deaths increasing by around 30 percent. In the U.S., projections suggest that by 2030, one-third of colorectal cancer cases will be in individuals under 50. It’s already the leading cause of cancer deaths in men younger than 50. In women, it now trails only breast cancer.

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The Healthcare Industry Needs a Course Correction

By STEVEN ZECOLA

The United States healthcare system has failed by any measure.

First, costs are out of control. For example, 17% of the country’s GDP is spent on healthcare. This percentage was less than half that amount in 1980. It is expected to continue growing to 20% by 2032. Seventy-five percent of these costs are attributable to chronic diseases.

Second, notwithstanding the highest percentage of GDP spent on healthcare of the top ten high-income countries, the US has the worst performance outcomes whether measured on life expectancy, preventable mortality through disease management, and even access to care through insurance coverage or other means.

Third, the agency overseeing the healthcare industry is the Department of Health and Human Services. HHS is organized by functions such as Clinical Health Services and Behavioral Health Services rather than organized by disease management. The five strategic imperatives of its 4-year strategic plan do not contain benchmarks for improving the health status of the population, nor concrete steps to achieve the benchmarks. There is no mention of costs.

Fourth, the industry is huge and has many different components from healthcare providers to equipment manufacturers, to researchers, to pharmaceutical companies, to genetic companies, to insurance companies and so on. Over 16 million people are employed in the industry, with 60,000 in HHS alone. At this level of aggregation, leadership and management prowess becomes watered down and there can be no driving force for across-the-board improvements in disease management.

Fifth, the industry spends about $100 billion per year on R&D in pursuit of FDA approvals. The cost of this development translates into more than $2 billion per approved drug. Once approved, the drug effectively gains a barrier against unfettered competition. Independent analysts have estimated the costs of this regulatory scheme vastly exceed the benefits. Yet the FDA holds firm in its approach, given that its primary objective is safety.

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Mental Health Crisis in Miscarriage–an Unrepresented Patient Population

By TAMARA MANNS

I walked into the emergency department already knowing the outcome. In these same rooms I had told women having the same symptoms as me, “I am so sorry, there is nothing we can do for a miscarriage”. I handed them the same box of single ply tissues I was now sobbing into, as I handed them a pen to sign their discharge paperwork.

Two weeks after my emergency room discharge, I continued to live life as if nothing happened, returning to work without any healthcare follow-up to address my emotional burden. Luckily, I had established obstetrician (OB) care with the physician who previously delivered my second child. At only nine weeks gestation I had not seen my OB physician yet, but I was able to follow up in the office to talk about my next steps.

After that two-week hospital follow up, I heard from no one.

Due to the environment of the emergency department, women often complain of unprepared providers with ineffective and impersonal delivery of miscarriage diagnosis and discharge education; this lack of emotional support can result in feelings of abandonment, guilt, and self-blame. Due to the psychological impact of pregnancy loss, a standard of care for screening and referral must be implemented at all facilities treating women experiencing miscarriage.

If I had not reached out to my healthcare provider after my miscarriage, I would have continued suffering through an aching depression without help.

Depression, anxiety, and grief are most severe in the first four months after miscarriage. The symptoms decrease in severity throughout the following year. These symptoms may influence future pregnancies by increasing maternal stress and fear, possibly leading to pregnancy complications.

In the United States (US), one in five women suffer with mood and anxiety disorders while pregnant, and up to one-year after delivery.

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A Baby Step Backwards

Bringing the Tools of Accountable Care to Maternity Care is a Great Idea – But This Sure Ain’t It

By VICTORIA ADEWALE & J.D. KLEINKE

How desperate are we to find some kind of good news about the sorry state of maternity care in America? To find out, look no further than the current cover of no less venerable a health policy journal than Health Affairs.

With the headline “Medicaid ACO Improves Maternity Care” jumping off the cover of its September issue, we were expecting great things from the article “Massachusetts Medicaid ACO Program May Have Improved Care Quality for Pregnant and Postpartum Enrollees” (Megan B. Cole, et al.). The headline certainly promises some rare good news for all of us working to fix the national embarrassment that is maternity care in the US in general, and the maternal mortality crisis in particular.

But alas, the article itself is one more reminder that process improvements are not outcomes improvements. It is also a classic case of earnest researchers’ tendency to torture retrospective data — because it happens to be available for study — into something that might be useful. While it would be easy to dismiss out of hand the listless findings of this study of data-convenience, the danger here is they may well provide yet more ammunition for skeptical payers not to pay for more care that numerous studies have shown patients desperately need.

The authors make a valiant effort with an elegant study design to glean what they can from the “natural experiment” of analyzing pre- and post-natal care delivered to pregnant patients before and after the implementation of Accountable Care Organizations in Massachusetts. But as another old saw goes: when you have a hammer, everything looks like a nail; and patient enrollment in a primary care ACO, as with this dataset, hardly counts as an independent variable with much power to predict the care utilization and outcomes of maternity care for covered enrollees.

It is well established in the literature – not to mention an accepted truism among providers and patients – that when most women become pregnant, the bulk of their care shifts from the primary care setting to obstetrician/gynecologists (OB/GYNs) and certified nurse-midwives (CNMs). Many researchers and clinicians believe that much of this shift occurs even before a confirmed pregnancy, as a consequence of fertility challenges and pregnancy planning.

The authors did find that pregnant patients newly enrolled in ACOs had a small increase in the number of pre- and post-natal visits.

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