Parkinson’s disease
The National Parkinson Foundation says on its website that not everyone will experience all the symptoms of the disease, “and if they do, they won’t necessarily experience them in quite the same order, or at the same level of intensity.” But it says the disease progresses in a typical manner in the following stages (U.S. Sen. Johnny Isakson’s neurologist has said that the senator is at Stage 1.5):
Stage 1 – Symptoms are mild generally and do not interfere with daily activities. Tremors and other movement symptoms occur on one side of the body only. Changes may be noticed in posture, walking and facial expressions.
Stage 2 – Symptoms start getting worse. Tremors, rigidity and other movement symptoms affect both sides of the body. Problems with walking and poor posture may become apparent. Completing day-to-day tasks becomes more difficult.
Stage 3 – Problems with balance and slowness of movement mark this phase. Falls are more common. Symptoms significantly impair activities such as dressing and eating.
Stage 4 – Symptoms become severe and very limiting. It's possible to stand without assistance, but movement may require a walker. Help is needed to perform activities of daily living.
Stage 5 – Stiffness in the legs may make it impossible to stand or walk. The person requires a wheelchair or is bedridden. Around-the-clock nursing care is required for all activities. Hallucinations and delusions are possible.
Source: The National Parkinson’s Foundation
11 days until vote
Friday marks 11 days until Americans vote in federal and state races on Nov. 8. All year, The Atlanta Journal-Constitution has brought you the key moments in those races, and it will continue to cover the campaign's main events, examine the issues and analyze candidates' finance reports until the last ballot is counted. You can follow the developments on the AJC's politics page at http://www.myajc.com/s/news/georgia-politics/ and in the Political Insider blog at http://www.myajc.com/s/news/political-insider/. You can also track our coverage on Twitter at https://twitter.com/GAPoliticsNews or Facebook at https://facebook.com/gapoliticsnewsnow.
Georgia’s three U.S. Senate candidates were sparring Friday over congressional term limits when the discussion dallied into a subject matter incumbent Johnny Isakson’s challengers had studiously tried to avoid.
The Republican's health had long been the subject of private rumblings before and after he announced in June 2015 that he suffers from Parkinson's disease.
Isakson’s openness about his diagnosis has functioned as a defense mechanism, banishing most discussions about his ability to fully serve a third term to the political margins. Yet there the Senate candidates were last week, treading into the politically delicate subject area during the race’s one and only televised debate.
“The best thing for Johnny, his family, our state and our country would be if he were not running right now,” Libertarian Allen Buckley said. “I talked to a lot of his friends who’ll tell me that confidentially.”
What followed was one of the most biting and emotionally charged exchanges of the hourlong debate.
“I think that’s a veiled reference to the fact that I disclosed a year and a half ago that I had Parkinson’s,” Isakson said.
Announcing that he had been diagnosed with the disease, Isakson said, “was the hardest thing that I ever did and also the best thing that I ever did. … I’ve told everybody I intend to win that battle, and I will win that battle.”
Buckley, 56, was not the first of Isakson’s political opponents to bring up the 71-year-old’s health, but he was the first to confront the Republican about it in such a direct and public fashion. His struggle to find a way to address the issue in a tactful yet purposeful way showcases just how politically fraught the road is for Isakson’s rivals who want to broach the subject.
‘A burden lifted’
On the campaign trail, Isakson generally won’t bring up his health proactively but will discuss it if asked.
Isakson said he felt like going public with his diagnosis was something he owed his constituents. Once he did, it “was a burden lifted off my shoulders,” the Republican said in an interview earlier this month.
Isakson says people he knows and people he doesn’t, including some wrestling with Parkinson’s themselves, approach him regularly at political events to thank him for being open about his diagnosis.
"I kind of consider it part of my job to be a role model for people who might have the disease or have a loved one who has it to say 'things aren't over, think positive, act positive and do positive things and you'll be fine,' " Isakson said.
That strategy is a notable one for a field in which Washington’s powerful tend to avoid discussing things that could make them vulnerable.
It’s largely helped him stave off public criticism from his opponents.
Isakson’s general election challengers had avoided broaching the subject until a dispute over the Atlanta Press Club’s proposed debate format prompted Buckley to explicitly complain that the Republican was receiving special treatment because of his health. The campaign of Democratic challenger Jim Barksdale also scoffed at the setup but avoided discussing Isakson’s illness.
When Buckley brought up Isakson’s age and energy level during the debate, the Republican swatted back with a dose of humor that drew chuckles from the crowd.
“I’m not going to hold your immaturity and inexperience against you,” Isakson said, “if you don’t hold my maturity against me.”
Barksdale, meanwhile, tried to keep to the sidelines. He voiced support for Isakson’s upfront strategy for discussing his health but later said the Republican should commit to serving a full six-year term should he be re-elected.
Earlier in the year, Isakson smoked out a primary opponent who tried to use his Parkinson’s to raise money this spring. Same for a bill in the state Senate that effectively presumed Isakson would not be able to serve another full third term in Washington.
Kennesaw State political science professor Kerwin Swint said perhaps other politicians who are less well-liked or well-known than Isakson could be damaged by attacks about their health.
“In (Isakson’s) case it’s probably going to be seen as desperation and possibly distasteful,” Swint said. “I just don’t see them getting much traction out of it.”
The health of the state's politicians hits a nerve in Georgia thanks to an infamous political succession scandal. At one point in 1947, the state had three governors after Eugene Talmadge died shortly after he won the 1946 election for governor. Another more recent saga occurred in 2000, when Zell Miller was tapped to succeed U.S. Sen. Paul Coverdell following his death from a cerebral hemorrhage.
Preparation
Part of why Isakson has been able to come out ahead of his critics in this area is because of preparation.
Before he announced his plans to run for a third term in the U.S. Senate, the Republican and his staff spent months building up a formidable war chest to help stave off potential attacks.
When Isakson eventually made the public announcement that he was suffering from the progressive neurological disease, his aides, doctor and allies took great pains to alleviate voters' fears. His staff released a 1,500-word Q&A about his Parkinson's diagnosis that included the phone number of Isakson's neurologist, Dr. Thomas Holmes of Marietta.
Taken together, the underlying message was that despite symptoms such as a shuffling gait, a faster speech pattern and stiff left arm, the disease had not slowed Isakson down or affected his job performance.
“I’ve seen no decline in the last little over a year, and so I wouldn’t expect that this would interfere with his duties, at least for another term of six years,” Holmes said of Isakson in an interview earlier this month.
“He’s as sharp as ever,” said former U.S. Sen. Saxby Chambliss, a friend of Isakson’s stretching back to their college days. “He and I are the same age. I can’t remember everything that happened yesterday — Johnny can.”
Isakson doesn’t hesitate to discuss his daily regimen, which starts with waking up at 5:30 or 6 a.m. for a half-dozen specific stretches that begin on the floor. The Republican also relies on two types of medication and a special type of physical therapy for Parkinson’s patients, Lee Silverman Voice Treatments, which focuses on strengthening vocal and motor skills.
Stewart Factor, the director of the Emory University Comprehensive Parkinson’s Disease Center, does not treat Isakson but said the progression of the disease, which affects movement and motor skills in up to 1 million Americans, varies from person to person.
“I usually tell people that on average they’re capable of doing almost anything they could do for about 10 years considering that they’re not a professional athlete or something like that,” Factor said. “If he’s had it three years and his term is six more years, I think it’s certainly possible that he could do that and function fairly normally. The issue is we can’t predict what’s going to happen down the line for someone.”
