[Jim091866]

Please take a look at this study it is somewhat involved but if I am reading correctly it recognizes a tool called microdialysis (ie.Glucometer) similar to that which diabetics use to measure the level of levodopa present. You establish a clinical level for the patient at which they respond-the dopamine level for them and there ya have it. What the hell is going on here, am I wrong or would this be a godsend? PLEASE TELL ME IF I"M WRONG!!

http://www.clinchem.org/cgi/content/full/43/5/740

[lou_lou]

you have heard this quote by plato?

Necessity is the mother of invention...
well there you go!

[RLSmi]

I'm familiar with the methods and lab equipment used in the study described in the link you posted. They are complex and very expensive, and unfortunately, the measurement of l-dopa is poorly suited for adaptation to a glucometer-type approach.
As you probably already know, each of us responds differently to the same level of the drug at different times and under different conditions such as when, what and how much we have eaten, as well as activity and levels of stress, so knowing our l-dopa levels at a given time isn't likely to be of much help.
Finding and keeping a consistent routine of sleep, activity, eating and taking medications works best for me. (And I'm actually able to accomplish it, occasionally! )

[Jim091866]

I have been up most of the night since this struck me. A number of studies have been done. Mostly the idea involves a type of catheter that has to be implanted similar to the diabetic pump. That treatment is based on continuous glucose monitoring and is thought to be the way that diabetics will be managed in the future as opposed to fingersticks during the day.This would be similar to the way that the levodopa would be monitored and administered, through the intestinal wall. Much of the oral dose is broken down prior to its absorption, hence Duodopa. We're not far off and I beg to differ as to the arguments that diet, activity, etc will make this impractile. Diabetics face the same problems and it seems as they have overcome these issues.

[Jim091866]

I apologize if I sounded argumentive. I was just very excited thinking of what that would do for us. Europe is already having trials of Duodopa so I dont think that this is far off, perhaps better than DBS. Not to mention being less invasive.

[reverett123]

"... each of us responds differently to the same level of the drug at different times and under different conditions such as when, what and how much we have eaten, as well as activity and levels of stress, so knowing our l-dopa levels at a given time isn't likely to be of much help.
Finding and keeping a consistent routine of sleep, activity, eating and taking medications works best for me. ..."

PD is both extremely complex and very individualized. We have different requirements at different times of the day and under different conditions and we each differ from one another in our own particulars. A consistent routine serves as a baseline and, from there, trial and error allows us to derive something that works. At least until something perturbs the baseline. A bad night's sleep. Spousal conflict. New medication.

A log of some sort is invaluable, especially at first. Yesterday affects today. When you go to bed and when you get up is more important than how much sleep you get. At least for me. What we eat is important but when is even more so. At least for me. Giving us a handful of pills and telling us to take three a day is pretty poor care.

Another reason for going to all that trouble is that it let's us reclaim some of our power. Losing control of our lives s a terrible blow. As you say, many of us are accustomed to the opposite way. Suddenly, we seem to be helpless. We are not.

A good book is "PD: Reducing Symptoms with Nutrition and Drugs" by Dr. Geoffrey Leader and Lucille Leader. Some of the chapters deal with nutrition and drug response, nutritional therapy for PD, dopamine precursors, cellular energy, blood sugar, how to figure out your own individualized L-dopa schedule, reducing dyskinesia, liver care, food intolerance, food additives, and that's just the first 14 of 36 chapters! And it is written for patients.

We are clever monkeys. Now, if only we can find the right broken stone....