Camilla Flintermann wrote :
<Friends--I'mposting this to the main list rather than CARE in the hope
someone
<can shed light from personal experiences.
<Yesterday Peter had to have an energency extraction of a broken tooth. The
<oral surgeon and staff were most accommodating, sensitive to his needs, etc.
<and the procedure went well, at 8:00 AM. We were home by 10:00AM, and as
<he was still dopey from the anesthetic he slept off and on all day and
evening-
<-he did take his Sinemet 10/100 every 2 hours as usual,but no extra doses.
<He was also on a crash dose (7 AM and 1PM)of Amoxycillin antibio., as he has
<mitral valve prolapse, and this is required before any oral surgery.
<He was a bit spacey off and on yesterday, due to the anesthetic--and po
<also the stress of the situation. This AM he woke feeling quite normal,
took
<10/100at 6 AM,8AM, 9:45 (before I left for church) and seemed fine. When
<I returned home about 11:30,in time for his next dose, he was in trouble,
<said his legs weren't working, couldn't stand to get out of his chair in
living
<room.....I gave him the next 10/100 early, at 11:45, dealt with other
<problems, and a half hour later he still was too wobbly to stand with my
help.
<I recalled that this was how he was the time he had to wait for the doc to
<discharge him from a day of hospital observation, as the stress of waiting
till
<9:30PM for the doc really got to him. On the theory that the stress level
may
<(like hard exercise has been said to do) cause the Sinemet to not work as
well,
<be used up faster, whatever, I persuaded him to take another 10/100 at
12:15,
<then sat quietly, played soft music, talked reassuringly. Within a half
<hour, he was able to get up and get from the living room to the bathroom
with
<my help,legs functioning OK!
<Here's my question--could it be that stress levels affecthehe way t
<Sinemet is used by the body---so that in a highly stressful situation one
<might be *undermedicated* even with normal doses? I should add that Peter
has
<never had dyskinesia, nor does he have more than very minor resting tremor
of
<hand when eating. His main problems are bradykinesis,bradyphrenia,and
<rigidity. (Plus others too numerous to mention!)
<If it seems this is a reasonable deduction from our experience, I can be
<prepared to ask neuro to increase his doses during the stressful time when I
<will be having surgery in April, and he has chosen to spend three days time
in
<a local NH, rather than try to cover(for that short time)24 hrs. a day here
at
<home. Any light that anyone can shed on this subject will be very welcome!
<Camilla Flintermann, CG for Peter, 78/7, Oxford,Ohio
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Dear Camilla,
I am in similar circumstances as Peter: ( 76 / 6 ) , right hand tremor almost
only symptom,
mitral valve deficiency, for which the dentist prescribes the same
anti-infection medicine, even for
just cleaning the teeth.
However, we differ in that I have had none of the symptoms that Peter had.
As a matter of fact, I am insensitive to the combinations of Eldepryl, Sinemet
CR and Amoxicillin.
This will probably not be of much use to you, but I thought that you might be
interested in a case that is quite similar to Peter's except for the absence of
stress.
Will
Will Kuipers
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