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Norman Ichiyen <[log in to unmask]> wrote: <<My wife has been diagnosed with PD now for 6 years. She is still working full time. Her current medication is 2 sinemet CR tablets per day (i.e. 2X200/50). She also takes Luvox. Over the last say 6 months she has started getting "off" periods in the early afternoon which last until her afternoon medication kicks in. By mid-evening she is very tired and she feels "like a log" by 9:00PM. Her feet and legs get very sore as well by the early evening. She has started taking a 1/2 CR in the early afternoon and then a full one around 5:00PM but this doesn't seem to help much. Does anyone have some suggestions? This constant fatigue in the evening is very dispiriting for her.>> Norm, It seems quite probable to me that your wife is working very hard (the usual efforts necessary to work full time PLUS motor muscles working against the counter-muscles that PD gradually lessens our ability to relax) - and she is getting muscle fatigue. The "rigidity" or stiffness eventually makes it so strenuous, I, at least, can work very hard to get a little done. I must do less to avoid fatigue. I must avoid using too much force so that I do not tear ligaments or do other strain damage at times when lifting or working with heavy things. This gets worse as lessened activity weakens my cardiovascular system. she should rest before becoming fatigued. May be that reducing to part-time is prudent. Or, rest an hour after working an hour. ron 1936, dz PD 1984 Ronald F. Vetter <[log in to unmask]> http://www1.ridgecrest.ca.us/~rfvetter/