Dear Jackie,
It would be helpful if you could describe the kind of pain Bob is
suffering in greater detail, and for how long it has been occurring.
If all the pain is due to muscle cramping, and if he has changed the
kind and/or amount of food he eats, it is possible he is suffering from
electrolyte imbalance: insufficient (one or more) calcium, potassium,
sodium, chloride, magnesium. Electrolyte imbalance can also be due to
loss of electrolytes through use of senna (Senokot), morphine, and/or
Paxil.
Insufficient calcium and/or magnesium can also lead to a severe cramping
of muscles called "tetany."
Also, both Sinemet and Compazine may lead to dystonia, a painful
cramping; Paxil may lead to myasthenia, or muscle weakness, and myalgia,
muscle pain.
Finally, although rare, neuroleptic malignant syndrome should be
considered if it has not been already; Sinemet, Compazine, and Seroquel
list NMS as a rare but possible concern. Murray Charters sent a valuable
post on NMS some time back.
My very best regards to you and your husband,
Kathrynne
> "Jackie G." wrote:
>
> My husband, Bob, (age 49) diagnosed eight years ago, had a Pallidotomy
> (rt. brain) 1997, has been on a steady decline sine his DBS STN (rt.
> brain also) in January, 2000. He is now in Hospice at home.
>
> Aside from the fact that he can hardly move anything, he is in
> terrible pain... in his calves, thighs, feet, back, neck and arms. He
> has difficulty swallowing his pills so I give them in applesauce.
>
> He is currently taking:
> MS Contin 15 mg every 12 hours
> Compazine 10 mg
> Roxicet 5/325 every 4 hours as needed
> Valium 5 mg, twice a day
> Artane 5 mg, 3 x a day
> Paxil once a day
> Seroquel 25 mg. 2 at bed
> Senecot 2 in morning, 2 at bed
> Quinine 325 mg 2 at bed
> Dalmane 15 mg. 2 at bet
>
> -2 reg 25/100 Sinemet
> -3 CR 25/100 Sinemet
> - the above at various times throughout the day.
>
> Obviously the pain meds are not working as he is in such tremendous
> pain, I must constantly pick him up (200 lbs) and move him to a
> different position, usually to the wheelchair, sofa and back to the
> hospital bed again, we do this over and over all day and all night
> long. If we are lucky he sleeps 3 straight hours, usually 1 - 2 hours
> and again wakes up from the muscle cramps.
>
> Needless to say this is an extremely difficult time (I feel especially
> sad for our 15 yr. old daughter who is living is this horrible
> ordeal). The doctors are puzzled by Bob's pain - they do not know why
> he is in such pain therefore they are reluctant to prescribe any
> stronger pain meds, so yesterday they added the Valium. To me and Bob
> last night his cramps seemed to be worse than before the Valium.
>
> If anyone has any ideas or thoughts we would appreciate it.
> Sincerely,
> Jackie Gilman
--
Kathrynne Holden, MS, RD
Author: "Eat well, stay well with Parkinson's disease"
"Constipation and Parkinson's" -- audiocassette & guidebook
"Guidelines for Medical Nutrition Therapy for Parkinson's disease"
& Risk Assessment Tools
"Risk for malnutrition and bone fracture in Parkinson's disease,"
J Nutr Elderly. V18:3;1999.
http://www.nutritionucanlivewith.com/
