REALLY OFF

["Will A. Kuipers" <103325.2723@xxxxxxxxxxxxxx>]

Camilla Flintermann wrote :

   <Friends--I'mposting this to the main list rather than CARE in the hope
someone
   <can shed light from personal experiences.
   <Yesterday Peter had to have an energency extraction of a broken tooth. The
   <oral surgeon and staff were most accommodating, sensitive to his needs, etc.
   <and the procedure went well, at 8:00 AM. We were home by 10:00AM, and as
   <he was still dopey from the anesthetic he slept off and on all day and
evening-
   <-he did take his Sinemet 10/100 every 2 hours as usual,but no extra doses.
   <He was also on a crash dose (7 AM and 1PM)of Amoxycillin antibio., as he has
   <mitral valve prolapse, and this is required before any oral surgery.
   <He was a bit spacey off and on yesterday, due to the anesthetic--and po
   <also the stress of the situation.  This AM he woke feeling quite normal,
took
   <10/100at 6 AM,8AM, 9:45 (before I left for church) and seemed fine. When
   <I returned home about 11:30,in time for his next dose, he was in trouble,
   <said his legs weren't working, couldn't stand to get out of his chair in
living
   <room.....I gave him the next 10/100 early, at 11:45, dealt with other
   <problems, and a half hour later he still was too wobbly to stand with my
help.
   <I recalled that this was how he was the time he had to wait for the doc to
   <discharge him from a day of hospital observation, as the stress of waiting
till
   <9:30PM for the doc really got to him.  On the theory that the stress level
may
   <(like hard exercise has been said to do) cause the Sinemet to not work as
well,
    <be used up faster, whatever, I persuaded him to take another 10/100 at
12:15,
   <then sat quietly, played soft music, talked reassuringly. Within a half
   <hour, he was able to get up and get from the living room to the bathroom
with
   <my help,legs functioning OK!
   <Here's my question--could it be that stress levels affecthehe way t
   <Sinemet is used by the body---so that in a highly stressful situation one
   <might be *undermedicated* even with normal doses?  I should add that Peter
has
   <never had dyskinesia, nor does he have more than very minor resting tremor
of
   <hand when eating. His main problems are bradykinesis,bradyphrenia,and
   <rigidity. (Plus others too numerous to mention!)
   <If it seems this is a reasonable deduction from our experience, I can be
   <prepared to ask neuro to increase his doses during the stressful time when I
   <will be having surgery in April, and he has chosen to spend three days time
in
   <a local NH, rather than try to cover(for that short time)24 hrs. a day here
at
   <home. Any light that anyone can shed on this subject will be very welcome!

   <Camilla Flintermann, CG for Peter, 78/7, Oxford,Ohio
   <pcflinte@xxxxxxxxxxxxxxxxx

Dear Camilla,

I am in similar circumstances as Peter:  ( 76 / 6 ) , right hand tremor almost
only symptom,
mitral valve deficiency, for which the dentist prescribes the same
anti-infection medicine, even for
just cleaning the teeth.
However, we differ in that I have had none of the symptoms that Peter had.
As a matter of fact, I am insensitive to the combinations of Eldepryl, Sinemet
CR and Amoxicillin.
This will probably not be of much use to you, but I thought that you might be
interested in a case that is quite similar to Peter's except for the absence of
stress.

Will

Will Kuipers
103325.2723@xxxxxxxxxxxxxx