Brian Collins,
I tried to open the Simon Coles'  Web site and got "Internet Explorer
cannot open ...Make sure the address is correct and  try again." Tried
twice.  Is it correct?  Thanks.
I just recently switched my intake of Sinement to 30-60 minutes before
meals and minimal protein until supper, as was suggested by a number of
folks on this List and it definitely seems to help my bradykensia.  (And I
also found a Movement Disorder specialist who presumably would have
mentioned this to me sooner - since my current neurologist had no clue -
and since I hadn't been paying attention here!  Couldn't get an appt until
Sept 8 though, but I don't feel quite as desperate now so that doesn't
matter.)

I haven't quite figured out yet when it's best to take the Permax, however.
 So I take it with the meals.

Bruce Anderson (51/2.5)
----------
> From: Brian Collins <[log in to unmask]>
> Hello Diane,  I think I can explain what is wrong about your mum's tablet
> schedule: Has anybody given your mum advice about when to take her
tablets,
> relative to meals? I suspect that someone has, probably when you were
> introduced to Sinemet. In a small number of people, some nausea is
encountered
> when patients begin taking Sinemet, and they are advised to take the
tablets
> with meals, because that reduces the nausea. Well, it certainly does
that,
> but it accomplishes it by a reaction with the protein; the protein in the
> food breaking down the levodopa, so that you get less nausea because you
get
> less Sinemet!!
>
> The schedule which you sent indicates that only the 3:00pm and 8:00pm
tablets
> are taken without meals, from which I conclude that your mum's basic
levodopa
> requirement is actually less than that delivwred by a Sinemet Plus (Known
to
> our friends in the USA as Sinemet25/100). This fact is masked most of the
> time by the meals, but this is a very imprecise way to do it, because of
the
> problem of knowing how much Protein is in the meal. The easiest way of
avoiding this interaction is by taking your tablet some 20 to 30 mins
BEFORE your meals.
> This should give you the full effect of the tablets, BUT, we know that
that is
> too much, so the problem is how to find the new optimum levodopa flow
rate.
> This is where I offer to use a computer program of mine to help find this
> target levodopa flow rate. If you want to have a go at it, take a look at
Simon Coles' Web site: The URL is as follows
>
>    http://james.parkinsons.org.co.uk
>
> Look for my name at the bottom of the home page and click on that. You
should
> find a couple of notes describing the way to generate data for the
program.
> If you want to ask questions, please do so, otherwise call me when you
feel
> that you are ready to go.
>
> By the way, where do you live in the uk?
>
> Regards,
> --
> Brian Collins  <[log in to unmask]>