Comments

[Bonander@xxxxxxx]

to: Mark Hirsch

Your comments on strength training are interesting.  If I read it right,
strength training is not beneficial to rigidity.  I think you said it can
worsen rigidity.  Since rigidity is almost a given in PD, is just range of
motion and normal activity sufficient exercise?  I think that would go
against current thinking.  What was the patinet medication status when
rigidity worsened?  I know that if I am OFF most types of exercise, except
reading the inside of my eyelids, are non-beneficial.


TO: Camilla Flintermann
Problem with Muscle spasms

First of all, the objective is to never enter an OFF period during the day.
 Taking 4 of the 25/250 Sinemet pills may be giving too much L-dopa at one
time (peak dose) and then slowly going down hill, then OFF and then taking
another pill and the cycle starts again.  I would suggest starting the day
with a 25/100 plus 1/2 of a 25/250.  Than every two hours take a 1/2 of
25/250.  This will give a better starting position and with lower doses given
more frequently, should reduce the peak dose and hopefully will not
experience OFF periods.

If a patient is having difficultly swallowing sinemet pills, there are two
suggestions that may help.  (1) crush the pill and mix it with apple sause.
 This seems ease to swallow. (2) put the pill is about 2 oz. of fruit juice (o
range, etc) and let it disolve (about 60 seconds) and then drink the result.
 This will decrease the time for a pill to become effective. ( I have heard
that it can be felt in as little as 10 minutes.)  As to the muscle spasms, if
they are in the foot, I like to roll my foot on a tennis ball.  This seems to
"break" the cramping muscles and feels good.

TO: Dar Newman

" I am 42 have had PD for 4 years and am currently taking 4 SInemet Cr a Day
and 45mg of Parlodel. "

If that is not a typing errorm I would say you are on Parlodel overload.  I
would not be surprised if you had only mentioned have of the problems.  It
has been my observation that young-onset PD responds better to Permax than
Parlodel.  At one time I was taking 12 - 15 Sinemet 25/100 plus 10 - 20 mg of
Parlodel.  I switched to Permax and found that I could drop my sinemet to 6
pills a day (25/100 sinemet every 3 hours) and 0.25 mg Permax pill every
three hours.  This ment taking a 25/100 sinemet and a .25 mg Permax every 3
hours.  This totaled 600 mg of L-dopa and 1.5 mg Permax.  The Permax leveled
the between dose flucations of sinemet.  If you are really taking 45 mg of
Parlodel, I would expect the birds to sing and butterflies to dance and people
 around you to wonder why the men in white coats have not been called.

(By the way, I was able to drop Parlodel one day and start Permax at the .25
mg level the next.  It was not necessary to be taken off Parlodel and then
start the slow process of starting on Permax.)  This is an observation.
 Please discuss this with your doctor before making any changes.


TO:  judith guttman

I have heard nothing but good reviews of Rosalyn Carter's book on care
giving.  Thanks for bringing it to our attention.


Regards,
Alan Bonander (Bonander@xxxxxxx)