Ellen, There are two movement disorder specialists (MDSs) with the Wisconsin Parkinson Foundation (WPF)* I was not pleased with the treatment I received from them last summer, and I will discuss that below. Due to the problems with the MDSs at the WPF and the significant fact that my supplemental insurance would not provide coverage for the MDSs at the WPF, I shifted to Dr. Karen Blindauer, a MDS with the Medical College of Wisconsin and Froederdt Hospital in Milwaukee. There is also another MDS in Milwaukee, an older male doctor (I forget his name), who works with Dr. Blindauer. I have no knowledge as to neurologists in Milwaukee. I am very pleased with Dr. Blindauer: she is young, dynamic, and competent. She listens, and she answers all my questions She confirmed the diagnosis by the MDSs at the WPF that I have drug-induced PD, and although she initially was quite adamant that I not take the drug, or any other drug like it, which probably caused my PD, she has come to realize that there has to be a balance between my psychiatric and movement disorder problems, and the medications prescribed for each, and she is working with my local Green Bay neurologist and my psychiatrist to reach that balance. Unfortunately she also has diagnosed me with something new, axonal sensorimotor polyneuropathy, which (she says) is outside her area of expertise as a MDS but which was not diagnosed by any of the many neurologists and other MDSs I have seen in the past six years. I have taken either my mother or my sister to each of my appointments with Dr. Blindauer, and they both have been impressed with her. I have not tried to contact her after hours, or on an emergency basis, so I don't know how available she is at those times, but I was initially given an appointment three months away but her clinic nurse listened to my pleas for an earlier appointment and called me when a cancellation occurred in a few weeks. I was not pleased with the MDSs at the WPF because they were not available after hours; one changed a scheduled appointment time without notifying me; they continually bashed the Mayo Clinic and the MDS there who diagnosed me with PD, my local neurologist, and even my orthopedic surgeon who did my hip and knee replacement; and they totally, totally disrupted my life and my medical care. My problems with the MDSs at the WPF started when the first MDS I saw told me that I had drug-induced PD and that the PD would go away when I stopped taking lithium, the psychotropic drug, which was causing the PD. This MDS took me off of all my Parkinson's and psychotropic medication without any titration and without any hospitalization. When I came in for my next scheduled appointment, he told me in person that he was not going to see me because he was leaving for the rest of the day. His patients were to have been called about his change in his plans, but I was not called, and I had made the 2 and one-half hour trip from Green Bay, by myself, to Milwaukee when I would have simply rescheduled the appointment if I had been notified he was not going to be there. He was rude, he did not apologize, and he did not ask me how I was. I was seen that day by the second MDS, who did have the grace to apologize for the appoinment mixup, but who, in my opinion, could not know or appreciate what I was like prior to the discontinuation of all those medications. He was not concerned about all the problems and complications I was having from stopping the medication. He told me that diagnosticly I had to have a special kind of MRI to rule out Wilson's Disease because the records from the Mayo Clinic indicated that the MDS there diagnosed me with PD before receiving abnormal lab results for the tests for Wilson's Disease. I told him that I was more concerned about the consistency, and continuity, of my medical care at the WPF rather than whether or not I had Wilson's Disease and my recollection was that the MDS at Mayo told me the results of the blood tests for Wilson's Disease and that the opthamologist at Mayo told me the results of her exam, which definitively excluded the possiblity of Wilson's Disease, prior to the official pronouncement by the MDS that I "probably" had PD, that my case very, very difficult diagnostically, and that sinemet would be prescribed to determine if the diagnosis for PD was appropriate. I suggested to this second MDS at the WPF that the blood tests for Wilson's Disease be repeated; these blood tests were repeated and they were normal. I had a second office appointment with this second MDS, but the complications from the abrupt change in my medication regime were overwelming. I was having significant problems, primarily psychiatric problems but also neurological/PD problems, such as severe jaw spasms, increased difficulty speaking, and severe dystonia in my feet and legs. There were many phone calls back and forth between me and both MDSs at the WPF. Calls, and most alarmingly after hours or emergency calls, were not returned in a timely manner or were not returned at all. The message at the WPF referred me to the Mt. Sinai Hospital switchboard operator who said she would give my message to the MDSs if they called in, but she had no means of contacting the MDSs directly and no one was listed on call. I questioned the office receptionist as to why the MDSs were not returning my calls when I was in obvious distress and my local doctors and local emergency room would not provide treatment/would not interfere with the treatment from the WPF MDSs. Medically, neurologically, psychiatricly I was a mess. There were turf wars among the MDSs, my Green Bay neurologist, my psychiatrist, and (believe it or not) my dentist. Finally the first MDS put me back on the sinemet, and it was agreed by the MDSs and myself that I would have a third office appointment in Milwaukee with myself and both MDSs. I took my sister, another attorney, along as my driver, caretaker, and legal representative to the appointment. I was examined by both MDSs and both proclaimed me to be "better." The first MDS stated that the stiffness and cogwheeling in my right arm and shoulder could still justify a diagnosis for PD, and that I obviously had a predisposition to having PD, and I would need to be monitored, but that, by Christmas, I would be better and better and better. My psychiatric issues, to which I gave first priority, were ignored. I first saw Dr. Blindauer in October, and she, of course, had no idea how I was before all the medications were stopped in June. I wasn't better at Christmas.; I'm not better now. I have now seen Dr. Blindauer three times, and she says I am "not worse," not better, as she had originally expected, but not worse. She says that it can take up to a year for the receptors in my brain to respond and to realize that the lithium, which suppressed the dopamine, is no longer there. It has been nine months, and, although I am arguable "better," I still have many PD symptoms and, more importantly, I am not stabilized psychiatricly. I am on the last drug which may substitute for the lithium, but I am having intolerable side effects. This drug has been stopped and now restarted to be titrated more slowly in the hopes that the side effects can avoided. It is, in effect, my last chance. It is understood that, if this does not work, I will be prescribed again the lithium which all three Milwaukee MDSs say caused my PD. I think the lithium, and my other psychotropic drugs, have damaged my brain by suppressing the dopamine for such a long time, 25 years on lithium, a total of 31 years on psychotropic drugs, and that the receptors in my brain probably can never fully recover. The causal connection between lithium and PD was not confirmed scientificly until 2001 with a study which involved rats. The length of time on lithium and the individual's sensitivity to lithium determine how the receptors in the brain respond to the stopping of the lithium. There was probably no way to know how the receptors in my brain would react/recover, if at all. The possibility that the PD would go away, or that the progression of the PD would be slowed, or that the severity of the PD symptoms would be reduced were such beautiful dreams, such hoped-for dreams, that I was willing, despite my better judgment, to stop all my medications at one time, cold tukey, and without any hospitalization or other precautions taken. I put my psychiatric health, even my life, in jeopardy. I didn't know that the past nine months would be hell, and I didn't know that I would end up exactly where I started. I wanted to believe those dreams were possible. I wanted to believe those who said that the PD would go away. Katie * I put in a request to Dr. Lieberman on "Ask the Doctor" re: a MDS in my geographical area, and he recommended the first MDS I saw at the Wisconsin Parkinson Foundation. WPF is affiliated with the National Parkinson Foundation which employs Dr. Lieberman. ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn