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At 07:04 PM 2000/05/01 -0400, i the interogator and bill the interrogatee wrote: >> I am currently 46 and I was diagnosed four years ago. My >> first neuro. put me on Sinemet 25/100 at two tablets a day. I >> noticed no change in my symptoms. My second neuro. put me on the >> same 25/100 at the same dosage of two tablets a day. Again, I >> noticed no change in my symptoms. This doctor bumped me up to >> four tablets a day, but there were still no changes in my symp- >> toms. My third neuro. changed the prescription to Sinemet CR >> 50/200 at two tablets a day, but (again) there was no noticeable >> change in any of my symptoms. >> >> My current neuro. put me on three tablets of Sinemet 25/250 >> per day. And, this was the first time that I had noticed any >> change at all. Some of the symptoms were actually reduced and it >> was noticeable. But, also noticeable, was a major dyskinesia in >> the form of my head bobbing a lot when I was talking. This neu- >> ro. then "bumped me down" to CR 50/200 at *four tablets a day* -- >> and we're talking about maybe pushing that up to five a day if I >> can find a way to wake myself at two in the morning. >> Ever since I can remember, I have had tremors in my hands. >> Nothing major, but enough to keep me from doing any kind of "de- >> tail" work with my hands. Initially, my *symptom* was what I >> would have called a twitch in my right arm. And, my "normal" >> shaking had become more noticeable. >> >> About a month or two after I noticed these symptoms, it had >> become bad enough to make me seek medical advice. In addition to >> the twitch, the neurologist noticed that -- as I walked -- my >> right arm didn't swing as freely as my left. >> > what were/are your symptoms? >> > post-diagnosis? ... >> >> In the last four years, I have had a variety of symptoms. At >> times, I would notice that I would unconsciously clench my hands >> tightly. I also developed an ache in my shoulder, elbow, or fin- >> gers of my right arm. A little later, I noticed that the muscles >> in the right side of my body would tense up. And, on occasion, >> my vision would blur slightly or I would require brighter light >> to read smaller text. >> >> These symptoms didn't always build on one another. Sometimes >> one symptom would fade while another became more prominent. >> There was no pattern -- no rhyme or reason I could detect. But, >> when recovering from an illness of any kind, the tremors seemed >> to worsen. And, in general, the symptoms seem to be at their >> worst in the morning but diminish a bit through the day into the >> evening. >> >> I have gone through a range of styles of tremors. What started >> out as a general shaking of the hands eventually changed into the >> classic "pill rolling" tremor. Then, it changed to a clasp- >> ing/grasping tremor. Either one was controllable at rest. And, >> the non-swinging arm stopped for a while and then changed into a >> raised-arm/clenching fist position on both sides. >> >> Eventually, I started noticing the "slowness of movement." >> Walking became harder and it would take quite a bit of effort to >> do simple things like walking the dog. And, getting into and out >> of cars and chairs became a real effort as well. I would have to >> expend a great deal of effort using my arms to pull me out and up >> into a standing position. >> > what were/are your symptoms? >> > 4 years post-diagnosis? ... >> >> At the moment, on the 4 x 50/200 CR, the symptom that is still >> noticeable is the tremors. I have noticeable tremors in both >> arms and both legs. As I remember, the off-Sinemet tremors were >> much worse than the current on-Sinemet tremors. And, except for >> the Sinemet-induced dyskinesia, these are the only symptoms I now >> notice. >> > in what way were they reduced by the 3x25/250IR sinemet doseage? ... >> >> The first thing I can say is that I generally felt better. >> People who knew me and saw me regularly said I looked better. >> The only symptom that I noticed -- as described above -- was the >> arm/leg tremors and the dyskinesia. >> >> > in what way were they affected by the 4x50/200CR sinemet doseage? ... >> >> The tremors worsened slightly -- almost imperceptibly. But, >> in the year or more since I've been on this prescription, the >> tremors have gradually worsened again to be, IMO, more noticeable >> and getting harder to hide. >> >> One other thing, I do have on-times and off-times. There are >> periods during the day when the tremors will all but disappear. >> While at other times they appear somewhat strong. I have not >> been able to determine a schedule or cause/effect or any type of >> pattern at all in these on/off times. >> >> > why does your neuro think a fifth 50/200CR >> > would benefit you at the cost of interrupting sleep? ... >> >> *Our* opinion is :-) that in the period of time between my >> last dose at 6 P.M. and my first dose in the morning at 6 A.M. >> that all of the Levodopa has been consumed or used. So, it takes >> a long time in the morning to get the first (and maybe the sec- >> ond) to kick in and provide some relief. >> >> So the theory is that the 2 A. M. dose might provide a sort of >> "running start" for the 6 A.M. dose to make it more effective. -----begin re-run----- my 'take' [i.e. my best guesstimate as a non-medico] on these two doseage levels: 3x25/250IR = [Instant Release Sinemet] 75 mg available carbidopa 750 mg available levodopa 4x50/200CR = [Controlled Release Sinemet] 200mg carbidopa less 25% = 150 mg available carbidopa 800 mg levodopa less 25% = 600 mg available levodopa these two doseage levels are the first ones you've had that meet the suggested daily minimum dose of carbidopa -----end re-run----- janet paterson 53 now / 41 dx / 37 onset a new voice: http://www.geocities.com/janet313/ 613 256 8340 PO Box 171 Almonte Ontario Canada K0A 1A0