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Reply to message from [log in to unmask] of Sun, 30 Mar > >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 >[log in to unmask] >* * * * * * * * * * * * * * >"Ask me about the CARE list for PD caregivers!" >* * * * * * * * * * * * * * Camilla, Hi Sometimes during extreme stressful times the sinemet is not as effective. Also, I liked the idea that another CG suggested (Bill(?)) about a personal aide while he is at the NH. MAYBE it would be nice. >Just a thought. I hope everything goes well for you both. Nancy > --