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Hello Fred, Thankyou for your interest. Percy had been on Permax for quite some time before his hip surgery and it had caused confusuion before the surgery, however, the dose had been cut down and he was able to tolerate it, after surgery was an entirely different story, whether this was due to the trauma of the surgery nobody could really tell me, as you said, knowledge of PD is somewhat scant in nursing staff and mostly they were asking me about various asapects of the disease. His Dr, awonderful man and an expert in PD, has now taken him off Permax and he now has sinemet 100/25 during the day which still produces a little confusion but only for a little while after taking the drug. We are very fortunate to have not only a Dr. who specializes in neurological diseases but a very sypathetic GP who does not hesitate to call on other medical experts if he doesnt know whats going on. Good luck in your search for information, I only know about Percy's experience with PD so am no expert but there are people on this group who certainly are or can point you in the right direction, feel free to write if you just want to *gab* it helps believe me to talk, Bye for now, Joan Joan Wollen [log in to unmask]