At 07:04 PM 2000/05/01 -0400,
i the interogator and bill the interrogatee wrote:
>> I am currently 46 and I was diagnosed four years ago. My
>> first neuro. put me on Sinemet 25/100 at two tablets a day. I
>> noticed no change in my symptoms. My second neuro. put me on the
>> same 25/100 at the same dosage of two tablets a day. Again, I
>> noticed no change in my symptoms. This doctor bumped me up to
>> four tablets a day, but there were still no changes in my symp-
>> toms. My third neuro. changed the prescription to Sinemet CR
>> 50/200 at two tablets a day, but (again) there was no noticeable
>> change in any of my symptoms.
>>
>> My current neuro. put me on three tablets of Sinemet 25/250
>> per day. And, this was the first time that I had noticed any
>> change at all. Some of the symptoms were actually reduced and it
>> was noticeable. But, also noticeable, was a major dyskinesia in
>> the form of my head bobbing a lot when I was talking. This neu-
>> ro. then "bumped me down" to CR 50/200 at *four tablets a day* --
>> and we're talking about maybe pushing that up to five a day if I
>> can find a way to wake myself at two in the morning.

>> Ever since I can remember, I have had tremors in my hands.
>> Nothing major, but enough to keep me from doing any kind of "de-
>> tail" work with my hands. Initially, my *symptom* was what I
>> would have called a twitch in my right arm. And, my "normal"
>> shaking had become more noticeable.
>>
>> About a month or two after I noticed these symptoms, it had
>> become bad enough to make me seek medical advice. In addition to
>> the twitch, the neurologist noticed that -- as I walked -- my
>> right arm didn't swing as freely as my left.

>> > what were/are your symptoms?
>> > post-diagnosis? ...
>>
>> In the last four years, I have had a variety of symptoms. At
>> times, I would notice that I would unconsciously clench my hands
>> tightly. I also developed an ache in my shoulder, elbow, or fin-
>> gers of my right arm. A little later, I noticed that the muscles
>> in the right side of my body would tense up. And, on occasion,
>> my vision would blur slightly or I would require brighter light
>> to read smaller text.
>>
>> These symptoms didn't always build on one another. Sometimes
>> one symptom would fade while another became more prominent.
>> There was no pattern -- no rhyme or reason I could detect. But,
>> when recovering from an illness of any kind, the tremors seemed
>> to worsen. And, in general, the symptoms seem to be at their
>> worst in the morning but diminish a bit through the day into the
>> evening.
>>
>> I have gone through a range of styles of tremors. What started
>> out as a general shaking of the hands eventually changed into the
>> classic "pill rolling" tremor. Then, it changed to a clasp-
>> ing/grasping tremor. Either one was controllable at rest. And,
>> the non-swinging arm stopped for a while and then changed into a
>> raised-arm/clenching fist position on both sides.
>>
>> Eventually, I started noticing the "slowness of movement."
>> Walking became harder and it would take quite a bit of effort to
>> do simple things like walking the dog. And, getting into and out
>> of cars and chairs became a real effort as well. I would have to
>> expend a great deal of effort using my arms to pull me out and up
>> into a standing position.

>> > what were/are your symptoms?
>> > 4 years post-diagnosis? ...
>>
>> At the moment, on the 4 x 50/200 CR, the symptom that is still
>> noticeable is the tremors. I have noticeable tremors in both
>> arms and both legs. As I remember, the off-Sinemet tremors were
>> much worse than the current on-Sinemet tremors. And, except for
>> the Sinemet-induced dyskinesia, these are the only symptoms I now
>> notice.

>> > in what way were they reduced by the 3x25/250IR sinemet doseage? ...
>>
>> The first thing I can say is that I generally felt better.
>> People who knew me and saw me regularly said I looked better.
>> The only symptom that I noticed -- as described above -- was the
>> arm/leg tremors and the dyskinesia.
>>
>> > in what way were they affected by the 4x50/200CR sinemet doseage? ...
>>
>> The tremors worsened slightly -- almost imperceptibly. But,
>> in the year or more since I've been on this prescription, the
>> tremors have gradually worsened again to be, IMO, more noticeable
>> and getting harder to hide.
>>
>> One other thing, I do have on-times and off-times. There are
>> periods during the day when the tremors will all but disappear.
>> While at other times they appear somewhat strong. I have not
>> been able to determine a schedule or cause/effect or any type of
>> pattern at all in these on/off times.
>>
>> > why does your neuro think a fifth 50/200CR
>> > would benefit you at the cost of interrupting sleep? ...
>>
>> *Our* opinion is :-) that in the period of time between my
>> last dose at 6 P.M. and my first dose in the morning at 6 A.M.
>> that all of the Levodopa has been consumed or used. So, it takes
>> a long time in the morning to get the first (and maybe the sec-
>> ond) to kick in and provide some relief.
>>
>> So the theory is that the 2 A. M. dose might provide a sort of
>> "running start" for the 6 A.M. dose to make it more effective.


-----begin re-run-----
my 'take' [i.e. my best guesstimate as a non-medico] on these two doseage
levels:

3x25/250IR = [Instant Release Sinemet]
75 mg available carbidopa
750 mg available levodopa

4x50/200CR = [Controlled Release Sinemet]
200mg carbidopa less 25% = 150 mg available carbidopa
800 mg levodopa less 25% = 600 mg available levodopa

these two doseage levels are the first ones you've had
that meet the suggested daily minimum dose of carbidopa
-----end re-run-----



janet paterson
53 now / 41 dx / 37 onset
a new voice: http://www.geocities.com/janet313/
613 256 8340 PO Box 171 Almonte Ontario Canada K0A 1A0