I am sorry about all the confusion I have caused with my posting being
digitally signed.  And, there is no personal intent to injure anyone with
the posting.  It was as follows:

I have remained silent long enough on the Ivan situation.  Ivan is a
good friend, a strong advocate of fellow PWP's and finally and most
importantly he is a human being ravaged by this insidious disease.  He
has shown he is all too human at times. For this he receives letters and
comments like the one below.

To me Parkinson's disease is like no other in that the typical day for a
person in a 3+stage becomes very cyclical.  On-off phenomenon is the
most difficult and unforgiving symptom or occurrence the human mind can
try to handle. To be functioning in a reasonable way one moment and
struggling to figure out why you can't move the next.  To me it is the
same as having a form of bipolar disease.  So much of this disease ends
up being emotional.  It drains one's energy level  PWP's feel helpless
to act at that moment to help themselves.  Often panic attacks occur.
If you ever had to deal with one you surely would not question the fear
of the inflicted concerns.

The problem for the patient is when the drugs kick back in everybody
thinks everything is kosher.  Well, while there is temporary relief for
the patient, there is confusion by laymen and people eager to point out
that the patient magically comes back from the seriously inflicted.  So,
therefore a patient may be capable of spastically hitting a golf ball
around the golf course one minute, the next minute he will pay for it
with either a long off period or a long and flailing session of
dyskinesias.

What I experience as most troubling is the directly related mood swings
I am scowling at everybody when I am off and smiling when the drugs are
on.  Manic swings that make people question your mental stability and
leave you lost to explain why.

If you are in fact in your early stages you can not have experienced how
difficult his symptoms are to manage or even stand.  When I first met
Ivan I thought he was a bit melodramatic.  But, after having experienced
some severe emotional strain from on-off phenomenon I do not question
his abilities from one moment to the next.  It is obviously tougher on
some than others.  Ivan doesn't receive strong family support, so he
often relies on newly acquired PCA's to help him manage his difficult
life.  Combine that with strong doses of Sinemet and one can become very
paranoid.  So what seems like an overreaction to their actions is often
another symptom of the disease.

Some may say that the treatment for PD has improved and therefore why
wouldn't there be corresponding symptomatic relief.  Well they have not
eliminated off time.  Until they do, PCA remain an important and
necessary staple in Parkinson's disease treatment.

Greg Leeman 40/30/28