[Albion]

Good evening,

in light of the obscene tragedy earlier today in Newtown, CT, I will try to be concise in asking for your help on the following issue--I only learnt of the existence of this forum this afternoon.

I am a 78 year old man, and was diagnosed with PD in 1997. I started taking Sinemet in 2010. My current dosage is two tablets of 25/100 three times a day. About three months ago I started having significant tremors and dyskinesia starting about 90 minutes after taking Sinemet and lasting for two to three hours. My initial thought was that these symptoms were/are triggered by the taking of Sinemet, but I now believe that they were/are end-of-dose reactions to the wearing off of Sinemet.

Dealing with end-of-dose dyskinesia is discussed at length in "The Parkinson's Handbook" by the late Dr. McGoon, a well-regarded Mayo surgeon. Putting it very simply, McGoon's schedule gives a more constant level of Sinemet which for five consecutive hours is not less than 70% of the total hourly doses as compared with two widely separated hours under my present regime.

I would be most grateful for any comments and suggestions as to how I should move from my present regime to the schedule discussed by Dr. McGoon, and in particular for the name of any doctor who is familiar with these issues.

With thanks and best wishes to anyone who has persevered to the end of this posting.

To quote eec "now is a ship--which captain am--sails out of sleep--steering for dream."

Albion

[ol'cs]

Originally Posted by Albion

Good evening,

in light of the obscene tragedy earlier today in Newtown, CT, I will try to be concise in asking for your help on the following issue--I only learnt of the existence of this forum this afternoon.

I am a 78 year old man, and was diagnosed with PD in 1997. I started taking Sinemet in 2010. My current dosage is two tablets of 25/100 three times a day. About three months ago I started having significant tremors and dyskinesia starting about 90 minutes after taking Sinemet and lasting for two to three hours. My initial thought was that these symptoms were/are triggered by the taking of Sinemet, but I now believe that they were/are end-of-dose reactions to the wearing off of Sinemet.

Dealing with end-of-dose dyskinesia is discussed at length in "The Parkinson's Handbook" by the late Dr. McGoon, a well-regarded Mayo surgeon. Putting it very simply, McGoon's schedule gives a more constant level of Sinemet which for five consecutive hours is not less than 70% of the total hourly doses as compared with two widely separated hours under my present regime.

I would be most grateful for any comments and suggestions as to how I should move from my present regime to the schedule discussed by Dr. McGoon, and in particular for the name of any doctor who is familiar with these issues.

With thanks and best wishes to anyone who has persevered to the end of this posting.

To quote eec "now is a ship--which captain am--sails out of sleep--steering for dream."

Albion

Dyskinesia is a problem for a lot of us and there are no easy or reliable methods for coping with it. It seems that we must accept this liability, and as it gets worse, becomes, as I've said " bad enough to make you just want to hide out" .
The only non drug method that I know of that helps is physical work. For some reason, when we force ourselves to move, even though it may be the last thing that we want to do, or think that we can do, dyskinesia is suppressed, albeit temporarily. Of course this is also conditional to risking a precipitous off, if you "run out" of available neuro transmitters. This is then governed by many factors, how much sleep you've had, what you eat, your emotional state, where the last remaining dose of dopa is and will it become available soon, and just a whole lotta "beats me" reasons. In short there is an optimum medication regimen for each of us, but it takes a lot of thought to manage this disease. And sometimes we just couldn't give two shifts about it, 'cause that's the way we feel.

[Songfellow]

Two things that generally tend help to reduce my dyskinesia are:

1) a small drink of wine or

2) a .25 mg tablet of Xanax (for more severe symptoms)

Also, as stated above, keeping loose and limber by getting enough exercise is important.

Steve