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Jack Orrell wrote 24 Mar as follows: Subject: Sinemet and Fatigue J.R. Bruman and Others: I do not wish to be an alarmist but have you and your medics considered angina as a possible cause of your back pain? Your pain apparently occurs between the shoulder blades. I had the same symptoms 17 years ago and it was the precursor of a severe heart attack. This incidently was long before I became a PWP or got involved with Sinemet. I sincerely hope you have already determined that your heart is not the cause. In my case, my doctor, at that time, ignored my reports of severe upper back pain until it was too late and the damage was done---which may account for my 'hyper' concern. Jack Orrell Thanks Jack, for good advice which we all should heed. As for myself, except for routine checkups (including ECGs) that don't seem to worry the doctor, I haven't reported the peculiar back pain that accompanies mental or physical fatigue, and I shall do that. Not trying to be my own doc, but I'm not worried either. Thanks perhaps to a lifetime of mountain hiking (pre-PD) and biking, my cardio- vascular shape isn't too bad (for age 75 and overweight). Blood pressure is up from 120/80 to 140/80, resting pulse up from 55 to 60, plantar pulse still present, last time I checked. The fact that the pain disappears promptly after a Sinemet dose also argues against a heart problem. But I agree, my regular doc should be kept informed. Cheers, Joe J. R. Bruman (818) 789-3694 3527 Cody Road Sherman Oaks CA 91403