[reverett123]

RLSmi, in his reply to the DXM thread, reminded me of something that I had wondered about.

Why is it so much harder to get back to "ON" once you have slipped off that plateau than it is to get to "ON" first thing in the morning?

I can't recall reading anything about this anywhere. If it were simply that med concentrations had dipped below a critical level then it would seem that all that was needed would be a little bump to get it up again. Obviously, it is more complicated than that. Ideas anyone?

[jcitron]

Originally Posted by reverett123

RLSmi, in his reply to the DXM thread, reminded me of something that I had wondered about.

Why is it so much harder to get back to "ON" once you have slipped off that plateau than it is to get to "ON" first thing in the morning?

I can't recall reading anything about this anywhere. If it were simply that med concentrations had dipped below a critical level then it would seem that all that was needed would be a little bump to get it up again. Obviously, it is more complicated than that. Ideas anyone?

I wonder if it could be the daily stress and an empty gut. We are, for the most part, least stressed first thing in the morning thus our first dose does a great job. We've also not eaten for 8-10 hours prior so there's nothing in the way to cut down the amount of medication we're actually consuming versus how much we're taking.


John

[paula_w]

I've always assumed it was food.

[lindylanka]

Agree about food. It not only affects the dose you take but also any residual that is in your system/

[imark3000]

Rick:
My main symptom is mild tremor. In my case I have noted that this symptom is not correlated with med concentration. This has lead me to seriously considering reducing the med dose and trying to coup with tremor by alternative "natural" therapies.
Imad

Originally Posted by reverett123

RLSmi, in his reply to the DXM thread, reminded me of something that I had wondered about.

Why is it so much harder to get back to "ON" once you have slipped off that plateau than it is to get to "ON" first thing in the morning?

I can't recall reading anything about this anywhere. If it were simply that med concentrations had dipped below a critical level then it would seem that all that was needed would be a little bump to get it up again. Obviously, it is more complicated than that. Ideas anyone?

[RLSmi]

Originally Posted by paula_w

I've always assumed it was food.

I agree, Paula and Lindy.
Taken on an empty stomach, the meds should get an almost express ride to the jejunum and so are probably present there at a high concentration which would be more efficiently absorbed into the blood. This in turn would provide for more dopa getting into the target neurons via amino acid transport proteins at the bbb.

[reverett123]

I just don't find a link between my eating and coming on. Let me propose another possibility-

Suppose that we have two dopamine buckets arranged so that bucket #1 overflows into bucket #2.

When we start our day, bucket #1 is nearly full from a trickle that accumulates while we sleep and use little of it. So, if we take the first meds of the day, it is a relatively short time (say one hour) until we have dopamine accumulating in #2 once #1 is filled.

We go through the day attempting to take meds in a way that keeps #1 full so that we can draw off #2. Every drop that we add to the total is immediately reflected in what is available to us.

However, if we misjudge and #2 goes dry and we draw on #1, once we do take a med then a certain amount of the dose is "wasted" topping off #1 before we can start the cycle with #2 again.

This means that we are better off keeping right around that point where #1 is full and #2 is just matching our needs.

Make sense? -Rick

[lurkingforacure]

Originally Posted by imark3000

Rick:
My main symptom is mild tremor. In my case I have noted that this symptom is not correlated with med concentration. This has lead me to seriously considering reducing the med dose and trying to coup with tremor by alternative "natural" therapies.
Imad

Imad,

We have also noticed sinemet does not help much, if at all, with tremor....and this was confirmed by our neuro. Oddly, the drug that helps the most with the most of our symptoms is mirapex, which we hate, because it has lousy side effects, but we've tried to wean off of it twice and simply could not. The pain and stiffness and rigidity were just too much.

So what does sinemet do for us? It's really hard to say, but mainly mood, and some pain relief. Maybe the mood improves because the pain dissipates, it's hard to know whether it helps both independently or just helps one but that ends up helping you feel better overall.

But it does not really do much for tremor, at least not for us.

[Conductor71]

I am inclined to think it may be dopamine store and the lack of stress upon our system when just waking. It in fact may have to do more with electrical circuitry requirements upon waking up. If you think of it, we go into a deep relaxation when we sleep from alpha to deeper beta waves where our system, much like an idle computer in hibernate mode, rather shuts down. It doesn't care about losing the inhibitory effects of dopamine. Upon waking, we reboot our nervous system but it a system restart so everything should flow.

Now continuing with computer analogy. It's 3 o'clock a All of a sudden your logic board is fielding several commands at once as come at you rapid fire: walk, take the garbage out, cook dinner all the while people may be present making emotional demands. This is life. This can all be stressful in and of itself; now layer on the PD. We take for granted, at least those of us good responders to Sinemet, how much that drug restores our function. So the normal humdrum most people call "life" is for us like completing a triathlon. Our brain thinks it has the dopamine in store or reserve and this is an easy draw when all your synapses have recharged and the only hurdle is turning on, but given the complexity of what goes on in our brain when we just initiate movement or look at a picture, is it any wonder our system is confused when all of a sudden eight different thing are competing for dopamine?

My thoughts...

Laura

[JoClay]

How important is it to maintain a strict schedule in taking your meds? His schedule calls for every 8 hours, but some times he needs it sooner. Other times, after 8 hours he is still feeling the effects of his last dose. Do you take it as needed, or when scheduled, regardless of how you feel?