A Steamboat Springs resident for 45 years, Sally TeStrake could type 90 words a minute as an executive assistant and speed through entering data in spreadsheets.

But in her late 50s, TeStrake began to experience physical symptoms such as her right arm would not swing when she walked, and a tremor started in her right hand. Her sense of smell diminished, and she began to experience some dragging of her right leg. The devasting diagnosis was the chronic and progressive neurodegenerative Parkinson’s Disease.

Now, after battling Parkinson’s for 12 years, fine motor movements such as typing are tough. Every week, TeStrake and other local residents with the neurodegenerative brain disorder must work hard to exercise regularly to maintain body movements.

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Due to the loss of specific brain cells, people with Parkinson’s produce less dopamine, a vital chemical that transmits messages to the part of the brain responsible for movement, according to the Parkinson Association of the Rockies. The movement disorder affects an estimated 25,000 Coloradans and impairs balance and coordination, slows movement and leads to tremors and stiffness of the limbs.

Dr. Tracy Vargas, a neurologist with UCHealth Neurology Clinic in Steamboat since August 2020, estimates she sees some 300 people living within a 100-mile radius region who battle Parkinson’s. Vargas said the four cardinal signs of the disease are resting tremor, stiffness, imbalance including frequent falls, and slowness such as shuffled walk or reduced facial expression and stiffness.

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“My clinical experience here is that the prevalence of Parkinson’s Disease here is higher … potentially due to having a larger retirement community,” Vargas said.

According to the national Parkinson’s Foundation, the disease is the second-most common neurodegenerative disease after Alzheimer’s. Nearly one million people in the U.S. are living with Parkinson’s, and that is expected to increase to 1.2 million by 2030. Nearly 90,000 people in the U.S. are diagnosed with Parkinson’s each year as the danger increases with age.

Parkinson Association of the Rockies CEO Jodi Brown stressed that “exercise is the one thing proven to slow the progression of the disease.” The nonprofit supports 80 exercise classes available for free in Colorado and Wyoming. 

Thanks to coordination from a volunteer board in the Yampa Valley established in 2015, local Parkinson’s patients have many options for classes such as yoga, snowshoeing, skiing, boxing, aquatics, movement and balance. The social aspect of the classes for people who have the common bond also is important.

When the gold standard medication of carbidopa-levadopa stops working for patients, they may face the serious decision to try Deep Brain Stimulation. The surgery implants electrodes in the brain to stimulate the production of dopamine.

Vargas said approximately half of her patients with Parkinson’s have had Deep Brain Stimulation surgery.

“I typically recommend DBS evaluation for patients with increasing medication dosage and/or increasing dosing intervals of medications, or frequent ‘medication wearing off’ phenomenon,” Vargas said. “I also refer early for tremor-predominant Parkinson’s Disease.”

According to the Michael J. Fox Foundation for Parkinson’s Research, the surgical procedure “can help ease motor symptoms and decrease medication needs in some people.”

Some Steamboat patients report good results from the brain surgery, while others are still on the fence.

Steamboat resident Mark Traum was diagnosed with Parkinson’s at age 46 in 2006. His original symptom was a resting tremor in his left ring finger, which he initially blamed on drinking too much caffeine.

In March 2023, Traum underwent the brain surgery, which helped to reduce his medication intake, yet he still battles balance and gate issues.

“In hindsight I would do it again. I’m still gaining a little bit,” Traum said.

TeStrake, who was diagnosed with Parkinson’s in 2012, said she was a good candidate for the brain surgery, which she underwent in April 2017 on “a leap of faith” with good results.

Although not fully understood by researchers, the causes of Parkinson’s aside from aging may be due to genetics — about 15% of cases — and environmental risk factors such as exposure to pesticides and pollutants.

“It would behoove people in the baby boom generation to learn more about neurological conditions such as Parkinson’s because I believe more are caused by environmental factors,” TeStrake said. “That should be a warning sign.”

Multiple Steamboat residents with Parkinson’s said they want citizens to know the disease can look and feel different for every patient, so they ask community members not to make assumptions if they don’t fully understand the disease. For example, Traum said citizens sometimes assume he is drunk or under the influence of drugs.

Patients, caregivers and support group leaders ask for patience because Parkinson’s can be challenging emotionally and cognitively.

“You go through a grieving period because you are never going to be the way you used to be,” Traum said. “Let the person grieve. The grieving process is holistic and the way the body comes to grips.”

Patients ask for patience from fellow citizens when waiting in checkout lines or providing food or retail service because someone moving slowly may be battling an incurable disease.