Janet,

Bob [Dales' son] seems to agree with you.  I am tryin it.
BBA.
-----Original Message-----
From: Dale O. Bowling <[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Date: Tuesday, September 22, 1998 9:50 PM
Subject: Sinemet Dose


>Bruce,

>I've been following your posts and responses re Prayer & a Wing.  It's a
>good thread.  There's been lots of meaty stuff tossed around in the related
>posts.  Much of it will help some of us a little or a lot in fine tuning
>our
>own drug regimen.
>
>How about trying your own 6 hour Sinemet dosage test?  You said you take
one
>tab 5 times a day or so.  That's about every three hours.  The next time
>your back begins to bother you, no matter when unless it's within 30
minutes
>of a regular dose, take an extra tab.  This is an extra, not a change in
>schedule.  Stick to our regular schedule and consider these "extra's" as
>just that.  If they make your back feel better I think you're
>undermedicated.  I'd make a cautious prediction that at the end of the 6
>hour test you will have been taken two extra tabs (you might try an extra
>one-half tab some time) and be pleased with how your back felt because you
>were "on" more of the time.
>
>I have a similar back problem and Sinemet fixes mine.   Of course the
>problem will come back (and is here now) when I'm undermedicated.  I just
>took an extra 25/100 and am chiding myself because I felt it coming 30
>minutes ago and ignored it.  Now it'll take another 30 or more to get back
>on.
>
>I respectfully suggest there is a better method than the one you are using
>to determine your Sinemet dose requirements.  You are currently taking an
>arbitrary amount (in my opinion anyway)--your body didn't tell you how much
>it wanted and I know of no medical logic except judgment (also called
>guesswork) that can be used to determine dosage needs.  I suggest you let
>your body make the decision, within reasonable limits of course.
>
>You know that some quantity of Sinemet makes you feel good for some period
>of time.  So take a couple of weeks and figure out by experimentation just
>how much and how often you need to take Sinemet to feel good almost all the
>time (at least 90%).  I think Sinemet doses are the most flexible (because
I
>have more experience with them) so I consider the doses of Tasmar or
Mirapex
>or whatever else you are taking as givens, i.e., I try not to tamper with
>the amount or timing without talking to the neuro.  I then structure the
>Sinemet doses around them.  I think you'll find few docs that will argue
>with a dosage when you go for a visit and tell them how good you feel and
>how you determined the amount and frequency.
>
>Please pardon my irreverence for suggesting the above.  It works well for
>me; may not work so well for others but there seems to be adequate logic in
>the method.  I think a lot of my neurologist and believe he and others do a
>pretty good job.  They don't have PD and don't live in my body, though, and
>I'm fairly insistent that I should tell them what I think I need in the way
>of Sinemet.  If my doc disagrees I'll listen carefully and most likely
>follow his advice.  I have found, however, that in life it's easier to
>obtain forgiveness than permission and I apply that philosophy here.
Rather
>than ask how much to take, I tell him how much I am taking and give him
>every opportunity to tell me why it's too much or too little.  His advice
>thus far, and I follow it, is to try to gradually reduce my reliance on
>Sinemet and increase either Tasmar or Mirapex.
>
>Good luck!!
>
>By the way, I'm using my Dad's computer for a day or two.  His name is Dale
>O Bowling and may appear on my email.  Sorry for any confusion.
>
>Bob
>~~~~~~~~~~~~~~~~~`
>Bob Bowling
>[log in to unmask]
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