Hello Pam Dalby,
I am prompted to respond to your message. There may be benefit in reducing
the amount of carbidopa by using 10/100 Sinemet rather than 25/100. Also,
if your mother is not sleeping with the SinemetCR at bedtime, it might be
best to discontinue using CR since it has high carbidopa in both pill
versions. It has been noted that younger patients handle CR and benefit
from it more than those of us who are older.
Two years of noticeable dementia is not an easy circumstance when age is
74. I am not a doctor, but read "everything" I can get hold of - and have
some experience with my own PD plus friends and family Alzheimer's -
including my mother who was very depressed from my father's dying in 1987.
She never 'accepted' that and recovered to pick up the pieces and start
living again. Instead, became withdrawn and demented, so is now alive -
but not here any longer. It is sad and difficult. We were unable to
discuss these things because of her denial of heer deficit when it was
first notable.
This 'conclusion' of mine is conjectural, but I am not easy to defeat in
debating most subjects - and I consider it credible that depression is
likely to produce 'apoptosis' if one is 'clinically depressed' for
significant time. In other words, I theorize that cognitive therapy by
one-self (introspection and conflict resolution to remove fears and doubts
and distortions) or with help from friend(s) or professionals in person or
reading the literature can bring one out of depression to an attitude of
enjoying living; but, if this depressed feeling is not replaced by becoming
interested in living for at least one significant goal, the chemistry of
the depressed state produces actual suppression of memory. If one loses
all joy of life and ceases to be active physically, the mode may be
Parkinsonian; if mental activity ceases, the mode may be loss of short term
memory to forget cognition that life is awful fear and anxiety about what
will happen next.
I hope these conjectures, though blunt and not offering any easy remedy,
are of some benefit to understanding what may be reality. I do wish you -
and all - wellness and success in being spunky to old age. I will append
an essay that I wrote some years ago - even though it makes a long message
longer.
Spunky People
Our bodies 'wear out'. Take care that this process does not get
accelerated by your 'indiscretions'.
Chance will place you in harm's way many times on it's own. You are
foolish to take chances - especially when the potential gain for you is
insignificant compared to the hazard. In other words, poisoning your
homeostatic system with booze, other drugs-chemicals to reduce inhibitions
is foolish. There are ways to reduce your inhibitions harmlessly.
Increased self-esteem will also decrease inhibitions. These often have
partial origin in early-life-events when powerful-righteous adults told you
to "Be Quiet!", "Shut Your Mouth!", or "You can't do anything right!".
Several of my older friends are examples that more should emulate. They
remain independent and are proud that they have made their own way. Not
all are still able to accomplish every task they wish to do. The wise ones
have accepted help, but they continue to care and do what they can - for
themselves and others. They have learned-know that loving-caring is the
essence of their personal happiness.
I invite the reader to consider Professor Stephen Hawking. His body has
been a 'disaster' for many years - due to amyotrophic lateral sclerosis
(Lou Gehrig's disease). He is a leading theoretical physicist and
professor.
The fear of dying may be part of the causes of the current phenomenon that
is extant - much of one's medical costs are paid during the last year of
life. A second major factor is the "practice" of doctors to do all that
can be done. I am compelled by my honesty and concern for the "common
good" to say that greed appears prominent as motivator. The excuse of
avoiding malpractice law suits is somewhat real, but integrity, honor,
honesty, professionalism, et cetera and loving-caring should each be more
important to a physician than is money!
Living longer may be worth much, but wasting wealth is immoral at all times
in our lives. It seems a poor bargain, for instance, that my father
'lived' his final ten weeks in pain and anguish in hospitals; with Mom and
family being miserable in sympathy and frustration.
"Spunky" people are young in spirit - pay little attention relatively to
their body's age or complaints - grow every day - change for the better.
We live, laugh, love, give, learn-change and remain happy - even euphoric.
We hope to accept .. and complete .. the termination of life with dignity.
ron 1936, dz PD 1984
Ronald F. Vetter <[log in to unmask]>
http://www1.ridgecrest.ca.us/~rfvetter/
