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Well. I had my appointment with my neuro this morning. All he had to suggest was to increase the Sinement to 4 25/100's/day from 3, adding the comment that "this disease does progress." I asked him if he happened to be a "movement disorder specialist" and he said no, just a regular neurologist. I really knew what his answer would be and probably have for some time. I always thought it amusing that I seemed to know more about it than he did, from you folks. But it isn't amusing anymore. He suggested I try Robert Wood Johnson Medical Center in New Brunswick, NJ. I just have to find out if one of the PD specialists there is on my HMO's (very short) list. Reading the varied suggestions and comments from Bernard, Ivan, Barb, Barbara, Margaret, Karen, Ronald and others - and then just reading the e-mail tonight - there is no easy answer it seems. Just a lot of trial and error. Just your suggestions were to increase all the meds, to cut back on them, to change which drugs are taken, to change the timing, to get a pallidotomy. Each worked for each of you. Now I have to find out what works for me. The first thing I'm going to do is to take the Sinement and the Permax 30-45 minutes before eating instead of at meals or between meals, and to eat most of the protein at supper. The second thing is to line up a new neurologist in NW New Jersey. I had a much better session with my Speech Therapist later in the day; it's really working. And I'm going to start Physical Therapy there soon as well. They said they can help me avoid the painful feet. The drug issue concerns me, though. Too many seemingly knowledgeable people say we should be taking as little as we can, especially in the early years (just today, for instance in David Harvard's discussion about his neuro's opinions. Thanks, you LAY PEOPLE, as my neurologist called you. B. Bruce Anderson (51, 2 1/2)