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I’m in my 8th or 9th year of taking sinemet and, as advertised, the trusty pill is losing its effectiveness (and/or my physical plant is gaining resistance to the drug, and/or the parko is living up to its "progressive disease" reputation, etc-etc-etc.) Meanwhile, in what I’ve come to consider a marriage made in hell, my low back has required two major operations (lumbar fusions) and still hurts like hell. My neurologist is intelligent and reasonably concerned, ditto my neurosurgeon. But neither physician ventures far out of his/her yard, into the situation I deal with 4-5 times a day: Every time the sinemet cycles toward the "off" phase, the parko makes a beeline for the surgery area and I get a pain-multiplying muscle spasm. This evil interaction has changed my life dramatically, and not for the better. Seems to me there must be someone, somewhere, who’s had the same or similar nightmare but who was fortunate enough to find a physician who was able to help. If you are that person, or if you can connect me with him/her, I’d love to hear from you. Andy Whipple