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In message <[log in to unmask]> Parkinson's Disease - Information Exchange Network writes: > For Peter Flintermann: > > You ask the question about meals and liquid sinemet. This is a problem for > most people using LS. The reason for the problem is the general short > staying power of LS. For most people the use of LS is at most at hourly > intervals. Squeezing in a meal and allowing for the stomach to empty in this > time frame is almost impossible. It is known that the pylorus, which > controls the emptying of the stomach, will open some 30 to 90 minutes after a > meal. That wide a margin is unacceptable for those on LS. > > The other problem is the possibility of bread and other food stuff might > absorb the LS and move it through the digestive track without releasing it. > I feel this is what happens to me. It may not be bread, but food in general > somehow absorbing the LS or at least diluting it in such a way as to render > the medication useless. > > Now LS can be taken at close as maybe 5 minutes before a meal. It mush be > taken on an empty stomach. The LS will get through the pylorus and into the > intestine where it will be properly absorbed. This, however, is not the main > issue. The problem comes with the after meal dose. This would be given on a > full stomach and maybe just lost. > > This is what I do. I learned this from a friend at a support meeting. What > was suggested was to add 1/2 of a 10/100 regular with the first food of lunch > and a full 10/100 regular with the first food in the evening. These pills > should be chewed or crushed to speed the benefit. Now I do not do this every > day. I only do this when (a) the meal is high in protein and/or (b) it is > important that I not have a down time after the meal. Some times I will over > medicate, sometimes under medicate but most of the time I will be on through > the meal and the following 3 or 4 hours after the meal. I must add two > things (a) I continue to take normal medications through this time and (b) I > am currently taking about 800 mg of levodopa daily. People taking > substantially less should adjust these kicker-patch meds downward. > > Finally, you mentioned the unmentionable in relation to liquid sinemet: > Sinemet CR. In my world of a narrow therapeutic region, the use of Sinemet > CR is toxic to my system, my life and my well being. I wish they had never > manufactured it. The use of CR is assured of producing one of three > conditions: 1-under medication, 2-therapeutic region, 3-over medication. Now > comes the killer -- it can keep one in one of these states for 2 - 4 hours. > That is where, for me, it damages my neurons. My therapeutic window is very > narrow. The probability of (2) happening is almost 0. That almost assures > me 1 or 3 -- neither of which I will tolerate. The result is if I think I am > under mediated, I will sip LS and when it does hit me, I will be in gut > wrenching dyskinesia. I find Sinemet CR to be highly toxic to my system. > The thought of mixing Liquid Sinemet and Sinemet CR brings pain to my > system. Now someone out there will say they are very successful doing just > this. I will almost bet they are always under medicated or their therapeutic > window is wide and the use of LS is unwarranted. I want you to know I am > very shy when I talk about this, much like a mother seeing her young child > playing with matches in a dynamite shed. > > Enough said on that. > > > Regards, > Alan Bonander > Age 55, Diag 11 yrs, liquid meds, pallidotomy > [log in to unmask] > San Francisco area (San Ramon, CA) For Alan Bonander I was interested in your comment about SinemetCR. My wife's experience was exactly the same. Regards - Bob Howard ([log in to unmask])