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Dear Sergio Guzik: I am in the same shoes as you. I am 54, consume about 800 mg of levodopa and 2 mg of Permax per day in liquid form. The pain you experience is most likely due to rigidity from the OFF times. The fact that your dyskinesia is less is good, but if you are now OFF your meds, something is wrong. Here are my suggestions: 1. Your first dosage of sinemet may need to be increased. I would suggest that it be somewhere between 75 and 100 cc. This will get you ON higher initially. The 50 cc per hour should hold you there. 2. If (1) doesn't do it, try increasing the hourly amount. Make 1000 cc of liquid Sinemet using 1000 cc of water, 10 25/100 Sinemet and 4 mg Permax. Now use 55 cc or 60 cc per hour. The muscle pain you reference in the OFF state is often related to under medication. I recently posted an article from the NPF newsletter concerning internal tremor and other problems all of which are resolved by increasing the meds. One other possibility is that you are not using Sinemet brand but are using the generic carbidopa / levodopa. I have reports of strength variation by some who are very sensitive to amount in their system. I have also reports of rash and similar reaction to the pill binding. All were resolved when they went back to Sinemet brand meds. Finally, I had a pallidotomy in May of 1993 in Sweden. The reason I went to Sweden was Dr. Laitinen's experience. He had the most experience of anybody at the time Somebody must be number one for each surgeon. Usually No. 1 is performed with an experienced surgeon present. As a mater of fact I hope there is an experienced surgeon there for No. 2 thru No. 10. I would think that No. 11 could be the surgeons first solo. Who did this surgeon train under? How many has he done while training? These are all very important questions. Regards, Alan Bonander ([log in to unmask])