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Dear Barbara: I would like to have a dollar for every pair of shoes I have that are worn-out on the outside of the foot due to twisting foot. I have always assumed this to be "an acceptable side effect" of our meds. My PD is on the left side yet the twisted foot is on the right side. It may be too much meds on the right side and just the right amount on the left. I always warn joggers and runners of the twisted foot problem as it can be very dangerous while running. We are not aware of the foot turning in. If this happens while running, shattered ankles, broken feet, etc. can result. Comments on Eldepryl: Initially the medical profession said we were to take 2 pills daily, morning and noon. That was because DATATOP said so. Now it is starting to come out that this dose level may be too high for many. I am hearing of 1 pill daily or even a half pill daily. I have switched to 1 5 mg pill daily and find that to be acceptable. When I first started on Eldepryl, my wife claimed I had a personality change. I became more demanding, had more paranoia and in general was more difficult to life with. Of course I remember none of the above. The DATATOP study along with other studies did show that Eldepryl slowed the initial progression of PD. This seems to hold for about the first two years. After this time, there seems to be little supporting evidence that Eldepryl does anything other than mask the symptoms. If that is the case, Eldepryl need not be continued after an initial couple of years. I still take one Eldepryl first thing in the morning. I find it a good kick start for me. Maybe it is the amphetamine high that I like. Many found taking Eldepryl and Sinemet at the same time caused symptoms similar to overdosing on Sinemet. This was twisted foot, dyskinesia (uncontrolled movement) and drug induced dystonia (cramps). The obvious suggestion was not to take the two pills together. It was better to separate them by at least one hour. Now comes the problem of nausea from Sinemet on an empty stomach. For Sinemet to achieve maximum potential, it should be taken on an empty stomach. This minimizes conflict with other protein in transport to the brain. Often nausea results specially in the morning when Sinemet is taken on an empty stomach. Here are some suggestions: (1) Wash the Sinemet down with about 2 oz. of a sweet fluid like 7-Up or Orange Juice and if necessary add a cracker or protein-free wafer to give some substance, yet no protein. (2) Try using Ginger Ale as the sweet fluid and add about 1/8 tsp of ginger to the Ale. Use this to wash down the first Sinemet. Ginger is an old Oriental herb used to treat nausea. What it does is empty the stomach. Just what was wanted.(3) Consider taking the CR version, such as Sinemet 25/100 CR or Sinemet 50/200 CR. These pills have a slower release of L-dopa and thus may not trigger the nausea center. I should add that the CR has given some problems when given as the first dose of the day. It is suggested a Lodosyn pill (25 mg carbidopa) be included with the first CR of the day. The reason is that L-dopa releases faster than the carbidopa, causing nausea. The Lodosyn can be only obtained from your doctor. They get free from the DuPont rep. directly. The final thought for problems with Sinemet is to start with an agonist such as Permax. Thus do not use Sinemet, just Permax. Expect some nausea as you build up. The benefits are (1) delayed use of Sinemet (2) Permax is not affected by protein (3) Permax has a 9 hour half-life vs. Sinemet of 90 minutes, thus longer lasting. The down-sides are (1) possible nausea (2) other side effects of Permax may be worse than Sinemet. I might add there are a number of "under the table" tests to see if Permax can be used before Sinemet. They are talking about levels as high as 6 mg per day or more. As always should all this fail, call your doctor or better yet, take advice from someone else. Regards, Alan Bonander ([log in to unmask])