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Dear List family.... I'm NOT the author of the following commentary, and am just acting as a conduit in order that you may read this commentary by PWP Tony Schoonenberg. Tony works for neurosurgeon Dr. Robert Iacono. Should any of you care to respond via email directly to Tony, his email address is: [log in to unmask] Commentary follows: Barb Mallut [log in to unmask] One Parkies opinion on low dose drug treatments I just read the latest in the continuing saga of the war against Parkinson’s patients, that’s right not Parkinson’s disease. Be sacrificed at the alter of neuroscience. This is in response to the recently published article by " J Neurology Neurosurgery Psychiatry 1999 Sep; 67 (3): 300-7". The premise of this paper has to do with the fact that we are told by the neurology community that Sinemet is toxic and should be limited. Everyday as patient advocate I see the suffering resulting from this fallacy, but this flawed opinion persists . Patient after patient is wheeled through our door akinetic and frozen in their wheel chair, because of not enough medication I can’t count the amount of parkies we have sent home doing well on large doses of dopa and dopaminergic agonists. Then six months later the family Doctor or Neurologist tells he/she that the amount of drugs they are taking is an overdose. Therefore they cut back on their medication at home, become akinetic, and fall, break a hip or choke on their food, or aspirate in the middle of the night, get pneumonia and go to the hospital. When they end up in the hospital because of lack of sleep, stress, fever etc… they become confused. When this occurs the disease establishment takes over, either the Parkinson’ s medication are cut further or stopped. The patients become confused and immobile. The well-meaning and over-worked nursing staff sees the anguish and stress in their patient. The nurse calls the Doctor asking for sedation. The Doctor orders Benzos or worse narcoleptics . The parkie who was doing fine when sent home on large doses of L-Dopa and other drugs, slowly and Page 2 painfully aspirates in an akinetic state and dies. When the disease establishment learns that the goal of drug therapy in Parkinson's is not to make the patient barely functional on the lowest dose of drug or as few drugs possible. The goal of treatment should be to make the Parkinson's patient as normal as possible no matter how many drugs are needed, then deal with the side effects as they come along. The most important thing is keeping the patient as normal as possible as long as possible. I can't believe that the low dose regimen reported in this article which resulted in only a nine year average survival was ethical research. Tony Schoonenberg, 01-07-2000