Reply to message from [log in to unmask] of Sun, 30 Mar
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>Friends--I'mposting this to the main list rather than CARE in the hope someone
>can shed light from personal experiences.
>Yesterday Peter had to have an energency extraction of a broken tooth. The
>oral surgeon and staff were most accommodating, sensitive to his needs, etc.
>and the procedure went well, at 8:00 AM. We were home by 10:00AM, and as
>he was still dopey from the anesthetic he slept off and on all day and evening-
>-he did take his Sinemet 10/100 every 2 hours as usual,but no extra doses.
>He was also on a crash dose (7 AM and 1PM)of Amoxycillin antibio., as he has
>mitral valve prolapse, and this is required before any oral surgery.
>He was a bit spacey off and on yesterday, due to the anesthetic--and po
>also the stress of the situation.  This AM he woke feeling quite normal, took
>10/100at 6 AM,8AM, 9:45 (before I left for church) and seemed fine. When
>I returned home about 11:30,in time for his next dose, he was in trouble,
>said his legs weren't working, couldn't stand to get out of his chair in living
> room.....I gave him the next 10/100 early, at 11:45, dealt with other
>problems, and a half hour later he still was too wobbly to stand with my help.
>I recalled that this was how he was the time he had to wait for the doc to
>discharge him from a day of hospital observation, as the stress of waiting till
>9:30PM for the doc really got to him.  On the theory that the stress level may
>(like hard exercise has been said to do) cause the Sinemet to not work as well,
> be used up faster, whatever, I persuaded him to take another 10/100 at 12:15,
>then sat quietly, played soft music, talked reassuringly. Within a half
>hour, he was able to get up and get from the living room to the bathroom with
>my help,legs functioning OK!
>Here's my question--could it be that stress levels affecthehe way t
>Sinemet is used by the body---so that in a highly stressful situation one
>might be *undermedicated* even with normal doses?  I should add that Peter has
>never had dyskinesia, nor does he have more than very minor resting tremor of
>hand when eating. His main problems are bradykinesis,bradyphrenia,and
>rigidity. (Plus others too numerous to mention!)
>If it seems this is a reasonable deduction from our experience, I can be
>prepared to ask neuro to increase his doses during the stressful time when I
>will be having surgery in April, and he has chosen to spend three days time in
>a local NH, rather than try to cover(for that short time)24 hrs. a day here at
>home. Any light that anyone can shed on this subject will be very welcome!
>
>Camilla Flintermann, CG for Peter, 78/7, Oxford,Ohio
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Camilla,
Hi  Sometimes during extreme stressful times the sinemet is not as effective.
Also, I liked the idea that another CG suggested (Bill(?)) about a personal
aide while he is at the NH.   MAYBE it would be nice. >Just a thought.
I hope everything goes well for you both.

Nancy

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