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Parkinson’s expert Mark Comes knows the disease both intellectually and physically.
Sitting in a booth at a Coney Island restaurant in the Detroit suburb of Waterford, Mark Comes (P’92) raises a cup of coffee to his lips with hands that shake only slightly.
Mark Comes
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“I took my medicine coming over here,” says Comes. “Mornings are the worst for me. It takes me about an hour and half to get out of bed, let alone brush my teeth, shave and put on a tie.” Like Mohammed Ali, Janet Reno and Billy Graham, Comes has Parkinson’s Disease. The 39-year-old father of two and pharmacy manager for Rite Aid specifically has Young Onset PD.
“I’ll never forget the day I got diagnosed,” says Comes. “I was mis-diagnosed back in ’99. I went about four years taking medications that wouldn’t work. They raised the doses so high I was almost a zombie.” In 2003, four days before his 35th birthday, Comes received a diagnosis more common for patients over 60 than under 40.
“I went to the doctor that day as a pharmacist who had all the answers, I came out as a patient who had no answers, only questions. In a way it was a blessing; we know what it is now, so we can treat it.”
Right now, as Comes is well aware, there are treatments for PD, but no cures.
Dr. Parkinson’s Disease
While the symptoms of Parkinson’s have been noted for centuries, it took until 1817 for science to recognize the symptoms as a discreet disease. That was the year English physician James Parkinson published An Essay on the Shaking Palsy.
Today, we know that PD is a progressive disease caused by a loss of nerve cells that produce the neurotransmitter dopamine. A drop in dopamine levels produces the characteristic shaking that those with the disease often display. Other symptoms include a shuffling gait while walking, a slowing of movement, involuntary movement, softness of speech and difficulty with swallowing. The progressive nature of PD means that sufferers especially those with Young Onset may live for years or decades with the disease.
“The awareness that we need to bring to this is so important, especially for a younger crowd. It’s one of the few diseases you can become disabled from when you’re 35, but not pass away until you’re 90,” says Comes.
He also notes one of the most frustrating aspects of PD by the time someone is diagnosed, they typically have already lost up to 80 percent of their dopamine-producing brain cells.
“We’re fighting to find out before that. By the time 80 percent are gone, you start losing your muscle function,” Comes says.
Mark Comes helps at customer at the Rite Aid Pharmacy in Waterford.
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Currently, treatment for PD consists of the drug levodopa (what Comes calls the “gold standard” of treatment), and also a class of dopamine agonists marketed under such brand names as Requip or Mirapex. (In addition to keeping up with new changes in drug regimens out of personal interest, Comes also volunteers his time as the pharmacy expert for www.yopa.org the Web site of the Young Onset Parkinson’s Association.
“The dopa-agonists basically mimic dopamine, so you get your functionality back. At a younger age you get a better response,” says Comes. “With Sinemet [carbidopa/levadopa combination], you have to take up to 10 tablets a day. Dopa-agonists you can take three times a day, and that’s a huge stride for a lot of people. There’s also a dopa-agonist patch that just got out of clinical trials. One of the hardest things to do first thing in the morning is take a tablet. You’re shaking, you’re spilling water I think the patch is going to be one of the best things that has happened.”
Even Better
Comes’ earliest career influence came from his uncle, Joe Nellis (P’60), who owned a pharmacy near Ypsilanti. “Whenever we visited he’d say, ‘See that candy over there? Take whatever you want!’ I thought that was the greatest thing.” The Muskegon native solidified his career plans in high school when his father pushed him to become the first in his family to attend college.
“Of the pharmacy schools that were around, Ferris was the closest. Then when I did some research, I found it was one of the best pharmacy schools in the nation. I was lucky to have it so close by,” says Comes. “It’s a great pharmacy program. It’s amazing it was basically in my back yard.”
While much of the advice he dispenses to PD patients happens via the Internet, Comes likes working face to face with his clients. And when he says that pharmacists save lives day-in and day-out, he’s not exaggerating. Comes cites the case of a man who came into his Rite Aid pharmacy last spring. Suffering from numbness and tingling, the man thought he was having a heart attack.
“He didn’t go to a hospital he saw a pharmacy and came in to get help,” says Comes. “He had started a new blood pressure medication about five days prior. That morning he went to a Starbucks, had two cups of coffee and bingo! At the end of the day, it’s not how many people yelled at you because their insurance didn’t work, it’s ‘How many people did I impact today?’ I want to go home at night thinking I impacted at least one person today. If it was two, even better.”
Toward a Cure
According to Comes, actor Michael J. Fox travels with more security than does former Attorney General Janet Reno.
He got to make the comparison at a Parkinson’s Unity Walk in New York’s Central Park. “I was just walking around, and there was Janet Reno. I asked if I could get a picture. There was no one around,” recalls Comes. “Then you see Michael J. Fox, and there’s a barrage people fighting to get close. You can tell he’s having a bad day. He’s signing autographs although he’s shaking and can barely write.”
Like Fox, Comes is doing his part in raising awareness about the disease. In addition to lending his expertise on yopa.org, he has given talks across the country about the disease, its treatment and hopes for an eventual cure.
“People are really hanging their hats on stem cell research,” says Comes of the hot-button issue. “I hate to see the debate at the level it is today of politics versus science, religion versus science. I’m impressed with scientists trying to find alternatives to embryonic stem cells, such as stem cells from amniotic fluid, the placenta or the umbilical cord.”
Despite the potential stem cells and other forms of research hold for Parkinson’s and other diseases, Comes is realistic about the possibilities of such research affecting the course of his own disease. He thinks we should be looking long-term. “When we find the cause, we find the cure. It’s that simple. The toughest thing to accept is that I’ll never see it. I’m not doing this for me, I’m doing it for my kids. You need to stand up for something. No matter what the cause is, whatever you do, donate your time it’s the most precious thing in the world.”
To contribute to the fight against Parkinson’s Disease, visit www.yopa.org. For more information, see the YOPA site or
e-mail Mark Comes at MarkRComes@yopa.org.
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