For David Langridge , Ida Kamphuis, and anyone interested.
Hello David. You have certainly raised a number of interesting points
which I want to address. However I'm going to have to ration myself or I
will end up writing reams which nobody can digest.
Let's start with the analysis program: It is designed to provide help to
anyone who is finding it difficult to get a satisfactory response from their
Sinemet ( I will use this term because it is becoming the standard, but we
all know that I could be referring to Madopar, or any of the generic
levodopa tablets or capsulles). I wrote the first version of my program in
1992, and I could have used it's help at least 2 years before that. It is a
very pragmatic program; it knows nothing about diphasic dyskinesia, peak
dose dyskinesia etc. - the philosophy on which it is based could be stated
as follows:
Our objective when we take our tablets is ideally to achieve a
constant rate of flow of levodopa to the brain so that the brain has just
enough flow to replace the losses due to natural functioning. It is
reasonable to assume that the rate at which we take our tablets, plus their
dissolve rate in the stomach, plus the amount of levodopa in each tablet,
will have an effect on what comes out of the pipeline at the other end.
I then turn that logic on its head and say: If I keep a record during
the day of how I am feeling, in terms of dyskinesia or tremor, plus any
other PD-related symptoms, then I can use this record to deduce what the
tablet characteristics are. Now we come to the best bit: Having analysed the
characteristics of the tablets, I can start playing 'what if' games, trying
different times between tablets, different quantities of tablets, all aiming
to achieve that elusive 'Condition zero' trace. If your recorded condition
appears to go up near the end of a tablet's life, there could be sevwral
reasons why - maybe you anticipated the time to take the next tablet too
soon, maybe its David's suggestion about the normal production system waking
up (What's left of them) and overshooting. - The program doesn't care.
What it does do is show you when and where you could reduce your Sinemet
intake to counteract that bulge. As I said : Pragmatic is the word to best
describe it. When you consider all the interfaces and adventures which the
Sinemet goes through, you may think that it's a miracle that there is any
relationship between when and how you take the tablet, and how you feel at
the other end of the line. Fortunately, I didn't know all that stuff when I
started, so I just went ahead and did it - and it seems to work.
Another aspect which impressed me when I first started to read about PD was
the use of all those long names, based on ancient Greek or Latin. Then I
realised that a lot of those long words were marker buoys, stuck there to
indicate some phenomenon which was not understood, but which could be
described. They use a dead language precisely because it is dead - It is
not going to confuse someone twenty years from now by the use of words
which have completely changed their meaning. Hence Substantia Nigra sounds
so much better than 'Black Stuff', and diphasic dyskinesia sounds better
than 'an enexpected rush of Dyskinesias at the end of a tablet'
I must stop and go to bed, Watch out for tomorrrow's exciting installment.
I do have some comments relating to diphasic thingys, in fact I feel a Chart
coming on. Would I upset too many people if I attached a GIF picture about
17K long? Please advise: I don't want to be flamed for misuse of the band-
width!!.
Regards,
--
Brian Collins <[log in to unmask]>
