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Hi all,

        Well, golly gee whizzzzz.  I finally have an on-topic post for
     the list and it "got lost" in the "mix."  Oh  well,  I  hope  the
     list-folk don't mind a little repetition ... I'll try again:

> Date: Tue, 25 Apr 2000 22:44:41 -0400 (EDT)
> From: "William A. Parrette" <[log in to unmask]>
> To: Parkinson's Information Exchange Network <[log in to unmask]>
> Subject: Six of one, half-dozen of the other -- some NON-PD & some PD content...
> ...
>         But, to try to post an actual on-topic message ...
>
>         There  has been a lot of talk about Sinemet over the last cou-
>      ple of days.  Now, I know that everybody is different and  every-
>      body  reacts differently to their medications.  But, I am kind of
>      curious why I am *so* different? ... or, at least it  seems  that
>      way to me.
>
>         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.
>
>         What confuses me is that many people that have been discussing
>      the effectiveness and dosage of Sinemet here in  this  forum  for
>      the last couple of days have said that they are taking the non-CR
>      25/100 -- and have been for many years -- and it does,  in  fact,
>      relieve their symptoms.
>
>         Now remember, I'm a paranoid introvert so  I almost can't help
>      from asking "why am I *so* different?"  Without being  too  face-
>      tious,  funny,  or  silly, does anybody have any thoughts on this
>      subject?  Thoughts, ideas, concepts, criticisms, witticisms, far-
>      eastern philosophies, ... anything?
>
>         Call  me  curious  today.  Curious if an on-topic post from me
>      will draw any responses.  And, as we say in Grand Funk land, keep
>      Shinin' On ...
> ...

        Then ...

> Date: Wed, 26 Apr 2000 19:51:07 -0400 (EDT)
> From: "William A. Parrette" <[log in to unmask]>
> To: Parkinson's Information Exchange Network <[log in to unmask]>
> Subject: Re: Six of one ...PD content / back to the knitting ..
>
> Hi all,
>
>         On Wed, 26 Apr 2000, the digest contained:
>
> > Date:    Wed, 26 Apr 2000 09:40:40 -0400
> > From:    janet paterson <[log in to unmask]>
> > Subject: Re: Six of one ...PD content / back to the knitting ...
>
> > ...
> > prepare for the jaNET INTERrogation! ...
>
>         I'm  ready,  ma'am.   But,  could  I  ask  you to turn on some
>      lights, untie me from this chair, take off the mask, and put away
>      the rubber hose?  Please?
>
> > ...
> > what were/are your symptoms?
> > pre-diagnosis? ...
>
>         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.
>
>         FWIW, if I can sit, undisturbed, and get my body in a relaxed,
>      meditative state, many times I can get the tremors to stop.  But,
>      the instant I move -- sometimes when I think about moving -- they
>      will start up again.
>
>         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.
>
>         And,  this  is actually more my idea.  But, the neuro. said it
>      wouldn't hurt to try it and see what happens.
>
> > ...
> > why you are on your fourth neuro? ...
>
>         With  the  first  doctor,  I had no insurance and the symptoms
>      were in their very early stage.  The second doctor chose to  have
>      some  elective  surgery soon after I became a patient and was un-
>      available for approximately six months.  The third doctor (excuse
>      the  use  of  "language")  pissed me off.  Now, I am on my fourth
>      neurologist.
>
>         So,  Ms.  "Kinsey," :-) may I take my had out of the Gom Jabar
>      now? ;-)

Bill--
  ...who thinks it is unnerving that a doctor calls what he does "a practice."
                                                                  ,--,
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