MR ROBERT A MARTONE wrote:
>
> Dear list members,
>
> My wife Nancy 52/22 is going to have back surgery on Wednesday to fuse
> L3 to L4 and place a rod in her spine to support L2-L5. The hope is that
> much of the back pain that she can not tolerate any more will be
> alleviated. In addition her overall posture is expected to improve
> dramatically by correcting the minor left leaning scoliosis that has
> been exaggerated by the many years of fighting PD and dyskinesia.  For
> those that may remember Nancy  had successful bilateral pallidotomies in
> 1995. Our hope is to further improve her quality of life by reducing the
> back pain and correcting the postural deficit.
>
> My question to the many wonderful list members is this. Since this is
> not a PD surgery, we will not have a cast of PD experts around  to make
> sure all medications, anesthesia's etc. work in concert and don't create
> unwanted consequences. However our neurologist will be consulting.  I
> have often seen on the list, references to drug interactions that should
> be avoided during hospital stays. Naturally I can't find it now but I am
> hopeful that some of you can reproduce such a list. Would those with
> that info please come forward? We will be discussing this with the
> Surgeon and anesthesiologist prior to surgery.
>
> Nancy's current med schedule is listed below. You will note that she is
> on Mirapex and has been for 2 weeks. I suspect there is very little info
> on Mirapex and surgery so me may be the pioneers on this one.  By the
> way the Mirapex has had little or no adverse side effects and seems to
> be producing benefits in areas of balance, speaking both in volume and
> articulation, sleep, and general attitude including self reliance. Off
> periods seem to be shorter by as much as 50% but their intensity has not
> been reduced yet. Could this be an emerging MIRAcle Parkinson EXperience
> . It's too soon to tell but it sure looks promising for Nancy. With
> regard to the off times, apomorphine was denied to Nancy  during the U.S
> . trails because of the prior pallidotomy surgeries. Once it is approved
> we plan to try that if the Mirapex doesn't help.
>
> Note: Nancy has titrated from .375 mg of Mirapex per day to 112.5 mg per
> day while titrating down on Permax from 3 x 1 mg (3 mg total) per day to
> 2 x .5 mg  (1 mg total)  per day. The plan is to be off Permax by
> Tuesday.  No changes in sinemet have been needed or tried yet because
> there have been no big side effects. It is worth noting that since the
> Pallidotomies Nancy has virtually no discernible dyskinesia in any drug
> combination.
>
> 26-Aug-97               Monday
> ------------------------------------------------------------------------> -----------------------------
> 4:30 AM         1 sinemet 10/100, if awake
> 6:00 AM         3 -125 Mirapex, 1 sinemet 10/100, 1 Loestril for estrogen
> balancing
> 7:30 AM         1 sinemet 10/100, 1 Amantadine, 1 Effexor
> 9:00 AM         1 sinemet 10/100, 1/2 Permax
> 10:30 AM                1 sinemet 10/100,
> 12:00 PM                3 - 125 mirapex, 1 sinemet 10/100, 1000 mg Vitamin C, 150 mg
> ferrous Furnate
> 1:30 PM         1 effexor, 1 amantadine, a Sinemet 10/100
> 3:00 PM         1/2 permax  .5mg, 1 Sinemet 10/100,
> 4:30 PM         1 sinemet 10/100,
> 6:00 PM         3 mirapex 125 mg, 1 sinemet 10/100,
> 7:30 PM         1 sinemet 10/100,
> 9:00 PM         1/2 permax  .5mg, 1 Sinemet 10/100,
> 10:30 PM                1  .25mg Clozaril, 1 Sinemet 10/100,
> 12:00 AM                1 sinemet 10/100, if awake
>
> Notes for staff and garegivers
>         Amantadine/Symmetril is red, Ativan is white and has an "M"side 1 and a
> 321 side 2
>         Clozaril is white and is kept at the bedside, Effexor has five sides
>         Flexoril is round and yellow with 2 max as needed
>         Mirapex is white witha U on one side and a 2 on the other
>         Permax is pink and rectanular, Sinemet 10/100 is blue
>         Ultram is white and 50 mg max is 6 a day as needed
>
> Thanks in advance for your help,
>
> --
> [log in to unmask]
> Kingwood, TXDear Bob & Nancy,
The best of luck to Nancy and her courageous battle with PD. I have
had pd 19 years now and the dskinesias, arthritis etc. have trigered
hip and back pain for "no apparent reason". I don't think the doctors
have figured this out yet but I understand Nancy's pain and wish you
both the very best luck! we will be moving back to houston, in the year
2000 when my husband retires from USX.
[log in to unmask]