Largely through the advice of members of this forum, I finally was able to convince my PCP to refer me to a movement disorders specialist. I had seen two neurologists before, and neither was very helpful.

This MDS neurologist said that the memory and cognitive problems I've been having aren't part of PD. It sounds reasonable, because PD does mostly have to do with movement, at least as far as I understand it. He has me using an Exelon Patch, which seems to be helping some. I've only been using if for four days, so it's still pretty early to make a serious conclusion.

I have a lot of PD symptoms and the Sinemet has made a huge difference. That much has been established for some time now. This is the first neurologist that has been interested in the cognitive part. I told him about when I was in a meeting in early 2007 when I really knew that there was a problem. I could see people talking and hear the words, but I couldn't understand any part of what they were saying. There was fatigue, sweating, and vision problems at the same time. This seemed to convince him that the cognitive part was real. All of the doctors to this point have been telling me that I'm depressed and that the depression is causing my cognitive symptoms. One doctor even went so far as to say that the depression was causing the PD symptoms--even though he could see that Sinemet was helping me.

So, for about the last six weeks, my local PCP and psychologist have had me taking Wellbutrin (bupropion), which is a dopaminergic antidepressant. At first, I took the XL 150 and didn't have much problem with it for the first few weeks. Prior to that, all of the seretonergic antidepressants had not helped and usually made me feel worse. But then my insurance company refused to pay for the Wellbutrin XL 150 (no generic version), and we tried bupropion SR 100 twice a day. Then I got really depressed. I started to do research on how to commit suicide and was trying to get my wife to leave me so she could go out and find some one better. I was at a real low point.

They stopped the bupropion SR but have me back on the Wellbutrin XL 150. It's expensive, but we're trying to get the VA to provide it. I'd rather not take it at all. It gives me tremors, bruxism, headaches and I still have episodes of depression. I don't know how they can think that making a person more depressed is helping with depression. For some reason, depression seems to be a favorite diagnosis for doctors. It's enough to make a person feel really depressed.

And, yes, the new diagnosis should help with my insurance claim. Of course, the neurologist ordered more tests. I'll have to wait a few weeks for the tests. The insurance company gave me 180 days to file a request for review of my claim, and that period is almost up. It's going to be close. In the meantime, I'm losing a lot of money from loss of income. I have trouble with this: Under doctor's orders, I'm not supposed to work more than four hours per day (and I'm not worth much during those four hours). I've paid the premiums for income replacement insurance since I started working at the university almost thirteen years ago. Still, the insurance company won't pay. It seems to me if the doctor says don't work, then the insurance company should pay. Evidently, that's not enough. A person can't simply be sick--they have to be sick in the right way.

It's also true, to my knowledge, that there is no definite test for Lewy Body Dementia. It's a diagnosis of exclusion, like idiopathic PD. The neurologist ordered a test to exclude ALS.

This was a long response and now I'm fatigued.

Thanks for the support.