I'm here to ask the expertise of this
learned on-line community.
My dear mother is a regular "visitor" here for some
three years, diagnosed with PD approx. five years ago.
The onset of what I now understand is classic PD showed up as a slight tremor in
her right hand, and was first noted in her writing (as a
teacher). By the time of her diagnosis, it had
progressed to the obvious tremor and "cogwheel" effect on the right arm and the
associated back pain.
A short run with Artane proved too much and she
stopped after five days, chosing to deal with the tremor
instead. She elected to stay away from the meds until
last year (by now PD was affecting the right side, walking balance, and
chin/tongue) and started on Requip.
Even at near maximum level, no appreciable
reduction in arm tremor was acheived (though chin and balance had improved
somewhat...), and she was switched to Mirapex (weaned off the old and onto the
new, per her PD specialist).
Following her last consult with her Winnipeg PD doc
and loss of effectiveness of the Mirapex, as of two weeks ago she's made the
transition (possibly too fast?) to Pergolide. This new med
(Permax) has
been the worst so
far. At the doctors recommended dosage, it's completely
knocked her off her game. Listlessness, back pain, weakness in her
legs... I'm worried enough now about the effect on her
morale: If she's unable to sleep and "recharge" from the effort of
the tremor, there's no telling where we'll be in a week.
My question(s): Does anyone
recognize this progression in use of the PD meds or does this approach
sound at all unusual?
Is Permax typically slow to "kick in" and and
start seeing results with? Finally, I have seen much reference to the application of Sinemet either early/late
in treatment of PD or in combination with other meds. Is
their a reason they'd commonly hold this med in "reserve" in a case like
this?
Your thoughts and input would be much
appreciated. My apologies for running so long with this,
and thanks very much in advance.
Norm Leonard
