 |
 |
Happy Mother's Day to all Moms! Pat Schark and I have made inputs about avoiding start of day dystonia. I have tried half tabs of Sinemet CR before retiring - finding this did not stop the dystonia - but did cause me to awaken and be mentally active during much of the night. I do that no more. I tried half a Sinemet CR 50/200 during the night this early morning upon awaking about 2 AM. I did this with only water as an experiment. Sleep did not come. The effect of medication started rather quickly - which surprised me. I had expected a delay. I did not fall asleep - and left bed and bedroom after perhaps an hour to keep my position changes from awakening my spouse - I did eat several crackers then since my stomach felt a bit queasy. This single data point changes the credibility of the major absorption occurring in the duodenum. It also caused me to recall that one of the active-speaker PD patients had mentioned keeping some Sinemet between lip and gum such that he could lick it occasionally while giving talks. A local group member whose swallowing difficulties - weight loss - led to feeding via tube to stomach was told not to use pulverized CR tablets through the tube. Perhaps it would be possible that some experimental absorption data on regular and CR versions could be accessed by doctors or pharmacists reading the list. Or, perhaps Joe Irr (sp) could cite a source or provide data. The new (APDA) YOUNG PARKINSON'S HANDBOOK states Sinemet CR is unaffected by proteins and can be taken with meals. However, it also states that l-dopa is not absorbed from the stomach - only from the duodenum. Confused? I am! CR releases slowly but immediately. Maybe it is absorbed before getting into the stomach? I cannot believe that it has a capability of passing through without delay! To relate today's dystonia effect for me: I sat or reclined as a couch potato in front of TV until about 5:30 with not problem. I then tried to start this message, but felt the start of left foot cramping. I abandoned the typing and took my usual half l-dopa/c-dopa 25/250, 5 mg Eldepryl, 500 mg vit C, and 4000 IU vit E with some grapefruit juice - chewed one prune. Had very mild occasional cramp while again resting for about 20 minutes. Ate small amount of mixed dry cereal and similar amount of several spoonfuls of All Bran. So, it seems to me that the release rate of CR is not quite sufficient to get me enough dopamine into the lower extremity motor neural portion. I will revert to taking my usual first meds on awakening if after 3am. I will be away from reading e-mail for a while, so welcome comments, but won't reply for a while. Take care to contribute - that feels good. Ron <[log in to unmask]> Ronald F. Vetter