My wife Olive (age 73 Pd 19 Yrs) was having an average of 4 hrs of
dyskinesias per day. I am presenting a brief summary of how I reduced it to
15 to 30 minutes per day.
1. I obtained figures for the amount of levadopa in the bloodstream
(the technical term is plasma concentration) for up to 6 hours
after a single dose of a given pill.
2. For the spreadsheet Excel I made macros which contained these
values. (Any good spreadsheet that automatically prints graphs
should work as well.)
3. I put the time in half hour intervals on the left hand side and
used the columns for the dose number and total plasma
concentration and average.
3. In the row representing the dose time and the column representing
the dose number, I clicked the macro for that particular pill.
4. I structured the spreadsheet so that it would add the total
plasma concentration in each row and put it in the "totals" column.
5. I also set things up to put the grand total up to a certain time
divided by the number of hours up to that point to get the
average dosage.
6. You also need one more column just before the previous two with
the same times as on the left hand side to give a base for plotting.
7. Specify that you want these three columns plotted, and presto you
have a graph of the plasma concentration throughout the day.
8. Now you can shift the pills around anyway you wish and the new
graph will always appear without you having to do anything more.
For a year and a half I printed a graph every day and pencilled in the
dyskinesias for that day.
Eventually I found that there was a level to which the plasma concentration
should not drop and also a maximum level which should not be exceeded.
These levels varied somewhat throughout the day. So I organized my wife's
pills so that the proper conditions would be met. Everything was ok except
the winding down at night.
Now I just set up a new graph if I am trying a pill change. In that way
I can avoid unnecessary bad times due to experimenting.
Having been through all this I can see that someone starting out could
arrive at the correct answer much more quickly it they understand that the
pills must be staggered so that the plasma level never gets too high or too
low. If you wait till the plasma level has dropped to the minimum before
you take the next pill, you are in for a rough time.
Remember that I only have had my wife to work with and she has
practically no storage capacity. I would like to know how this system would
be with someone is not so far advanced.
I would be very glad to work closely with anyone who would like to try
this system to see if they could get around their problems. I will give you
the figures that I used for my macros and I will help you in any other way
that I can.
Robert Naylor CG for Olive (73 Pd 19) ([log in to unmask])
