Dear Michel,
Michel Margosis wrote:
> Last week, our
> neuro increased the medications from 350 mg 450 mg dopamine to correct
> end of dose pains which normally indicates insufficient dopamine. This
> apparently seemed to arrest or even reverse some of the progress we
> thought we had achieved. The hallucinations and psychosis that had been
> waning, were returning.
I noted that there is no dietitian on the team; are the
staff making sure that Barb is given her Sinemet at least 30
minutes before her tube feeding? If she is getting liquid
Sinemet via G-tube, it should be possible to titrate her
levodopa quite closely, minimizing the end-of-dose problems.
She should receive the liquid Sinemet ahead of the tube
feeding, so that it can take effect before the food is
ingested.
Before considering Hospice, I would make very sure that her
food-medication regime is being looked after properly.
You and Barb are in my thoughts and prayers as always.
My very best regards,
Kathrynne
--
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/
