At 04:46 AM 1/30/97 -0500, you wrote:
>On Thu 30 Jan, will johnston wrote:

>> I find that the type of exercise makes a tremendous difference. Walking and
>> a little jogging does not seem to use up the dopamine. Yard type work which
>> involves gross or substantial movement of the arms & torso make little
>> difference.
>>
>> Exercise involving fine motor skills uses me up [and the Ldopa/dopamine] in
>> a hurry. If I have to handle papers, screw in a  screw with an ordinary
>> screw driver, count paper money, etc, I am "off" rather quickly.
>>
>> Will
>> And here's to long "ons" and short "offs"
>>
>> WILL JOHNSTON   4049 OAKLAND SCHOOL ROAD
>>                 SALISBURY, MD 21804-2716
>>                 410-543-0110
>> Pres A.P.D.A.  DelMarVa Chapter
>>
>>
>Hello Marty and Will.  Will: I find your experience difficult to explain
>based on the  report which I quoted in my previous post. This says that if
>you allow up to 1 hour after taking a tablet before you start exercise,
>your blood levodopa levels will be unaffected by the exercise.
>
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FROM WILL:
The type of medication makes a difference. I am on plain Sinemet 25/100's,
Entacapone which merely extends the life of Ldopa in the torso [works like
an assistant to the carbidopa [or the bensaride sp? in Madopar]] and
Eldepryl. The controlled release Sinemet takes an hour to work...I get
effect of plain Sinemet in 5-7 minutes or less on an empty stomach.

>The other point which you raise about jobs which require fine motor skills
>using your dopamine very quickly, is equally hard to understand. As I
>understand it, dopamine can be imagined as a small lever, which switches
>powerful devices (our muscles). The dopamine merely instructs the
>muscles to expand or contract, and is not used at a greater rate when
>we are thinking hard, nor when we are exercising violently.
>
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FROM WILL:

I visualize the dopamine more as an electrical glue - wire cleaner. Signals
come from the brain to a junction box [sort of like a mixer for those into
audio hardware or a mixing faucet for those more into plumbing]. Nerves
relay messages from the junction box to the various muscles. The problem is
the connections in the junction box are "iffy," and the signals may not get
through -- sort of like the problems in household aluminum wiring which
becomes oxidized and only part of the electricity gets through or like the
volume control [variable resistor - rheostat] on a radio which after a few
years lets only part of the music through and there is static which
corresponds to dyskinesia. Dopamine forms a conductive bridge to pass the
signals from the brain to the muscles - sort of like spitting on the
terminals of flashlight batteries to make the currrent flow better.

Following the wiring-battery analogy, oxidized aluminum wiring surfaces do
not transmit electricity well [create resistance] and heat will be generated
when the wires transmit electricity. The heat may speed oxidization causing
more resistance which causes more heat which causes more etc. [Aluminum
wiring is now banned in most applications because the heat can result in
fires.] On flashlight batteries, heat may dry up the spit and the light goes
out.

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>  I would suggest that what your experience shows, Will, is that you can
>do the jobs such as sweeping the yard in a condition where you are at a
>relatively low level of medication - that is, more Off than On. - a state
>in which you could not possibly cope with delicate jobs. In fact,
>delicate jobs demand a greater degree of control from our medication
>than coarse physical work, and it is much more difficult to achieve the
>correct tablet dose to allow you to do the fine work for a prolonged
>period of time.
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WILL SAYS:

True to a point. After working with paper I am not able to do much of
anything for a while. I use the phrase, "I used myself up."
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>   What I am trying to do here is find explanations for your experience
>which are consistent with the findings in Paper A, which strikes me as a
>well-thought-out piece of work which should be respected.  As far as the
>original question about the duration of a tablet goes, i suggest that if
>you check, you may find that you were getting a part of the penalty
>due to starting your exercise too soon after taking the tablet.
>
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WILL SAYS

There was a physical therapy article about 3 years ago which pointed out
that the life of Ldopa/dopamine shortened with exercise.  I don't remember
the citation, but I remember thinking, "That's worth an article? Anybody
like me already knows that." Then I found that it was  a "new" finding.

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>On a purely practical note, I strongly suggest that the most effective
>way of coping with shorter duration of tablets while exercising ( i.e.
>the experts got it wrong, and it wouln't be the first time) is to bring
>forward the time for the next tablet, and not to take an increased dose,
>as that would probably exacerbate (good word, that) any tremor which you
>may have.
>
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WILL SAYS:

An extra half a Sinemet tablet as a booster helps.

In presentations I have made to physical therapists I emphasize that
exercise when "off" is an exercise in frustration.

I would be interested in your views
>
>
>Regards,
>--
>Brian Collins  <[log in to unmask]>
>
>
And here's to long "ons" and short "offs"

WILL JOHNSTON   4049 OAKLAND SCHOOL ROAD
                SALISBURY, MD 21804-2716
                410-543-0110
Pres A.P.D.A.  DelMarVa Chapter