"We thought it was a miracle, but the doctor told us we have to give credit to the medication, too," says UCI Health Parkinson's patient Ana Maria Grinovero. Photo by Jared Novakovich
Ana Maria Grinovero relished her active, independent life. When she wasn’t working as a seamstress in Florida, she was jetting to see her daughter in Los Angeles and relatives in Argentina and her native Spain.
While visiting Spain in 2019, Grinovero, then 74, noticed her left leg was shaking while driving. At first, she thought it was due to the bumpy roads or the rental car’s balky manual transmission. But the trembling continued when she returned home. Soon her doctor diagnosed her with Parkinson’s disease and it progressed rapidly.
She had to quit her job, sell her house and move in with her son, who lived in a nearby Miami neighborhood.
“First, I started to fall, Then I couldn’t sit up. I couldn’t walk. I couldn’t dress myself. I couldn’t get on my bed," Grinovero recalls. “Finally, I couldn't cut my food or pick it up to eat."
She was in a wheelchair when she first met with Dr. Nicolás Phielipp, a specialist with the UCI Health Parkinson’s Disease and Movement Disorders Program, in January 2021.
No longer. At a recent checkup, Phielipp was delighted to see Grinovero, now 76, walking unaided and to hear about her latest travels, thanks to a new drug regimen.
What is Parkinson’s disease?
Parkinson's disease, which affects an estimated 1 million Americans, is a progressive disorder that damages dopamine-producing neurons in a part of the brain that controls movement. Symptoms include involuntary tremors, stiffness and problems with balance and coordination, according to the National Institute on Aging.
As neural damage progresses, patients also may experience mental and behavioral problems, difficulty walking, talking and sleeping, as well as depression and mood changes. Most people are over age 60 when they begin to develop Parkinson's symptoms.
No cure exists as yet but medications are available that can help alleviate Parkinson's disease symptoms and improve quality of life, says Phielipp, an associate professor of neurology at the UCI School of Medicine. He will be discussing the latest research on the neurodegenerative disorder at the annual UCI Health Parkinson's Disease Symposium on Nov. 5.
Finding expert help
When Grinovero’s daughter was finally able to fly to Miami at the end of 2020, she was shocked to see how much her mother’s condition had deteriorated in little more than a year.
“She was skin and bone and very weak. She couldn’t get off the chair by herself,” says Jessica Grinovero. “We saw her just a year prior and she was sick then, but she went downhill so fast. She had no energy, strength or desire to do anything. Mentally, she was in a dark place."
Through a friend, she learned about Phielipp who, like the Grinovero family, had come to Southern California from Argentina. At first, she was afraid to bring her mother to Los Angeles in her fragile condition in the middle of the COVID-19 pandemic. But the thought of losing her was much scarier.
From her first appointment with Phielipp, mother and daughter were impressed. "The first thing that shocked us was that he spent about an hour with my mother,” says Jessica Grinovero. “He was so caring, patient and wonderful."
Phielipp was able to speak with the elder Grinovero in her native language and learn about her life and medical history. He also evaluated her physical strength and ability to do basic activities like pushing and pulling with her arms and legs.
Customizing therapy
Next, he assessed the medication she had been prescribed in Miami, added a new one to the mix and he recalibrated them for maximum effect.
That is complicated because Parkinson's disease develops differently in each person, which requires customizing the treatment for each individual.
"There are more than 20 drugs we can consider but the appropriate combination is developed through careful monitoring and collaboration with the patient,” says Phielipp.
"Levodopa and carbidopa can, in many cases, improve symptoms significantly for a long time — so sometimes that you’ll have dramatic outcomes where patients who couldn't even walk are now traveling, like Ana."
Taking back her life
Three months into her new drug regimen in spring 2021, Grinovero began to feel better. Her strength gradually returned, the trembling stopped and her granddaughter was amazed that she was able to stand up again.
Even her outlook improved. Several months later, she embarked on the first of three overseas journeys.
Most recently, Grinovero traveled solo from Los Angeles, where she now lives with her daughter, to see her son in Miami, then to Argentina and on to Spain, where she spent a month visiting relatives in Malaga.
She may need periodic adjustments in her medication dosage but should continue to do well for many years, Phielipp says. At some point, however, other interventions may be needed.
Meanwhile, Phielipp and his UCI Health colleagues are testing alternative therapies in a number of clinical trials for Parkinson’s disease. Learn more about UCI Health clinical trials for Parkinson’s disease ›
Planning ahead
While her daughter still worries about her mother’s safety, she also marvels at how much the trips have improved Grinovero's physical and emotional health.
"She feels capable of doing things. She can wash the dishes. She takes walks. She goes to soccer games to cheer for her grandchild. She is much happier."
Grinovero is already planning a pilgrimage of sorts to Italy to thank St. Padre Pio, to whom she prayed during the depths of her illness.
"We thought it was a miracle, but the doctor told us we have to give credit to the medication, too," says Grinovero. "The treatment has worked perfectly. Now I want to go back to work and I want to drive again."
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