The Foreign Service Journal, May 2019

38 MAY 2019 | THE FOREIGN SERVICE JOURNAL their comments about others with medical issues prompted me to avoid disclosing my diagnosis for several years. Some of them made clear they would step over colleagues in their pursuit of promotion up the ladder. Managing the Illness At the same time, my wife and I planned for the future. We needed to transition her back into the workforce to eventually take over support of the family while I continued to work for as long as possible. I put myself on a rigorous routine of exercise and diet to maintain my ability to function in “able-bodied” society. This was a daily battle. I started doing strength and stretching exercises when getting up each morning to counteract the muscles and tendons that seem to tighten up overnight. At the time, my left foot was just beginning to drag a bit, but I could still run and ski, and Canada was a beautiful place to get out and exercise! I walked as much as I could—at least a mile every morning and a mile in the late afternoon or evening—to keep my legs strong and make walk- ing automatic again instead of a conscious process. After a few years of playing crypto-PD patient, I was relieved when State Department medical officials were accommodating and granted me a Class 2 medical clearance, which allowed me to continue my career and still left available to me many developed and developing countries with access to good health care. I was posted to Belgium, where my family and I remained for the next four years. I was plagued on and off by terrible reactions to the European-sourced PDmedications, which left me alternately nauseated or drowsy. My problems withmobility and balance became more pro- nounced, and I had to work harder tomaintain and retrainmy legs eachmorning to avoid the tyranny of small steps that PD imposes. Despite their charms, quaint European cobblestone streets and older mass transit systems were not disability-friendly. I routinely went to the gym—at least three times a week—tomaintain strength and balance. I believe that exercise and weight training remain the most essential self-help one can practice, in addition to diet. A devout coffee drinker, I gave up caffeine to reduce its effect on my tremors and minimize any interference with sleep. I also limited my intake of refined sugar and sodium, which was pretty challenging in the pastry-rich environment of Belgium and France. Although my wife and I had always been mindful about maintaining a healthy family diet, a lower protein regime eating less red meat and more fruits and vegetables proved necessary and helpful. There is no doubt that this type of diet relieves some of PD’s nonmotor symptoms. These years of trying to balance my Parkinson’s with a hectic work schedule continued when I took on a final four-year assignment in Tel Aviv, followed by shorter assignments in Paris and Reykjavík. In all, I was able to continue working for another 15 years after my initial diagnosis, taking up diplomatic responsibilities in some of our most active posts. Fortunately, I had the Americans with Disabilities Act behind me to facilitate “reasonable accommoda- tion” in the workplace, when I needed items such as ergonomic keyboards and better desk chairs. Desks that permit standing and good chairs when sitting are essential for people with Parkinson’s. For persons working in the U.S. public and private sectors, the ADA provides support and protection to those who continue to operate in the mainstreamworkplace. However, working in inter- national environments has distinct challenges in that manage- ment does not always ensure reasonable accommodations. A Stubborn Survivor Fortunately, when I opted for early retirement a few years ago at 58, I found the Parkinson’s Foundation was the ideal group through which to channel my energies and practice my economic and science officer skills. Through its online resources and refer- ences I researched PD and the drugs and treatments for it thor- oughly. I enrolled in a number of clinical studies, trained with the foundation to become a patient advocate and became an activist for furthering PD research, lobbying Congress to increase funding for training and boosting awareness of the growing numbers of patients, soon to reach one million Americans. Ultimately, I had the good fortune to join the foundation’s People with Parkinson’s Advisory Council, where we try to guide the agenda we pursue as the voice of the PD patient and caretaker community. Although my sons may have never known their father without a limp or a “shaky” left hand, as they used to say, PD has not kept us from traveling and enjoying many experiences and outdoor activities together as a family, just as we did before my diagno- sis—albeit with some modifications and more preplanning. It has been 18 years since that bleak day in Ottawa, and I still try to maintain the structure and discipline of my working life. I wake up Fortunately, I had the Americans with Disabilities Act behindme to facilitate “reasonable accommodation” in the workplace.