Thank you.:)

> ----------
> From:         Charles Countryman
> Reply To:     Parkinson's Information Exchange Network
> Sent:         Thursday, August 30, 2001 2:39 PM
> To:   [log in to unmask]
> Subject:      Re: Sinement CR
>
> SAM-e is  S-adenosylmethionine, a dietary supplement (in
> the U.S.).  It is not covered by my medical insurance.
> My family physician agrees with me that it helps with
> mood, maybe movement, and may help my body (especially
> liver) manage the other meds.  I think that my
> neurologist is probably an agnostic about this.
> > I'm rather new to this and hate to sound ignorant, but what is "SAM-e?"
> > Nancy
> >
> > > ----------
> > > From:         Charles Countryman
> > > Reply To:     Parkinson's Information Exchange Network
> > > Sent:         Thursday, August 30, 2001 2:04 PM
> > > To:   [log in to unmask]
> > > Subject:      Re: Sinement CR
> > >
> > > [log in to unmask] wrote:
> > >
> > >  > Charley,
> > >  >
> > >  > I read with great interest your timing of sinemet doses.   Would
> you
> > > please
> > >  > share with me what dosage you are on?
> > >  > I am trying to relate sinemet to meals and snacks.
> > >  >
> > >  > Thanks Dean
> > >
> > > Dean,
> > >
> > > Here is where I am at after about 8 years of trial and error
> adjustments
> > > to my meds (under supervision of my family physician and my
> > > neurologist). My experience is that the meds. complement each other,
> so
> > > I did not separate the Sinemet CR from the rest.
> > >
> > > The bottom line for me is although the effects of PD and its meds have
> > > steadily progressed to the point that I took disability retirement
> (this
> > > time last year), I now have predictable "on" hours several times/day
> and
> > > tremor is almost never a problem.  If there is such a thing as an
> > > "average day" for a PWP, I would say that my "on" times exceed my
> "off"
> > > times (Bradykinesia primarily) by about 25 per cent.  Also, I usually
> > > get about 6 hours of good sleep/night.
> > >
> > > I found that Sinemet CR alone was not adequate for me to deal with
> > > Bradykinesia.  Adding Ropinirole helped me a lot. (I have also tried
> > > Parlodel and Tasmar.) However, probably because my blood pressure has
> > > always tended to be on the low side of normal, I have to be careful
> with
> > > it.  An experiment with increasing the amount of Ropinirole lowered my
> > > blood pressure level too much.  Because of this, I always take Sinemet
> > > CR at least a hour before any Ropinirole.  (see more about Ropinirole
> at
> > > the end)
> > >
> > > I take-
> > > Amantadine 100 mg x 2/day
> > > Selegiline 5 mg x 1/day
> > > Sinemet CR 200-50 x 4/day
> > > Ropinirole 1 mg x 3/day
> > >
> > > also SAM-e 400 mg x 2/day and standard multiple vitamins plus extra E.
> > >
> > > about 0600  Selegiline & Sinemet CR w/medium cup of orange juice
> > > 0615  SAM-e with a sip of orange juice
> > > 0700  Amantadine w/breakfast of fruit and cereal with reduced fat,
> > > lactose free milk or fruit and 2 waffles
> > >
> > > 0800  Ropinirole w/my concoction of 1/2 coffee and 1/2 lactose free
> milk
> > >
> > > I usually am moving pretty good between about 0830 and 1100.  This is
> > > the best time for me to do T'ai Chi exercise and walk or garden.  If I
> > > feel like it, I'll take a mid morning break with either coffee or
> black
> > > tea and something sweet to eat.
> > >
> > > When I start to slow down around 1100, I take another Sinemet CR and a
> > > Ginseng tea break or water if I am not at home.  I usually get another
> > > good hour from about 1130 to 1230.  I take another Amantadine
> > > w/vegetable juice, usually while making a low protein lunch.  After
> > > lunch about 1300, I take Ropinirole, usually w/green tea at home or a
> > > coke if I am out and about.
> > >
> > > Early afternoons are usually pretty good for me, if I can do things at
> > > my own slower pace. But I am definitely much slower then than my wife,
> > > former work associates, and my ten year old son!  I take another SAM-e
> > > w/water or juice about 1400.
> > >
> > > About the most difficult time for me (Bradykinesia again) is late
> > > afternoon.  Since both of my doctors have advised me to moderate the
> use
> > > of Sinemet as much as possible, I use this time just to sit and listen
> > > to or watch the news on radio or tv.  My son is still at school and my
> > > wife is a teacher at school then anyway, so it is a manageable
> > > inconvenience.
> > >
> > > I take another Sinemet CR about 1630 w/juice or a soda when it is hot
> > > and Ginseng tea when it is cool.
> > >
> > > Evenings are pretty good for me, unless I get into a crowded situation
> > > or something that requires multi-tasking.  I take my last Ropinirole
> > > with dinner around 1800.
> > >
> > > I start getting very slow around 2130.  So I take my last Sinemet CR
> > > around then w/Chamomile flower tea.  I wait until about 2300 to go to
> > > bed. (Because I have found out that every time I take Sinemet CR
> within
> > > about 30 minutes, no matter the time of day or amount or type of
> liquids
> > > I have drank, I need to relieve my bladder.)
> > >
> > > Note about Ropinirole.  It definitely helps me move.  But it also
> causes
> > > me to have "sleep attacks" within 30 minutes, if I am not moving
> around.
> > >    This caused me major problems when I had outside employment,
> because I
> > > did not have the freedom to just get up and move around.  I would fall
> > > asleep at my work site.  Also, it is not safe for me to operate a
> motor
> > > vehicle while using Ropinirole.  It is connected to a near accident,
> > > when I dosed off about 30 minutes after taking it (in the morning and
> > > after a good night sleep).  In another incident, I blanked out in the
> > > early evening about 30 minutes after taking it, causing an accident
> > > (fortunately no one was injured).  I have since voluntarily given up
> > > operating motor vehicles while taking Ropinirole.
> > >
> > > Charley
> > > 50/PD diagnosed 1993
> > >
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> > >
> > >
> >
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