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Well I just passed my one year diagnosis anniversary. I also had my first visit with my new neuro (my last one informed me last month that he was leaving the area). My new neuro is also a MD specialist but seems to be more informed. It is about a 45 minute drive to her office with no traffic, but this seems a small investment in time relative to the time I plan to live with the disease. Her treatment philosophy is different from my previous neuro and she informed me that she was not happy with my 4 per day 25/100 Sinemet dosage. She is from the 'Don't treat with Sinemet early' club so it appears we will be experimenting with some new med combinations. She also informed me that I would be starting a regular 30 minute a day exercise program. Goody! Goody! My sarcasm aside, I really like her. She seems interested in PD and in treating me. In addition, she is very personable with good bedside manner. Funny how things can work out. I do have a couple of questions for the list. She is adding Permax to my Sinemet. I'd like to hear about list member experiences with the drug especially in early onset members. Also, I get to take another trip with Prince Vallium for an MRI on my neck. Anyone know what she is looking for? She wasn't specific, but indicated that disorders of the spinal column can sometimes mimick PD symptoms. Another point she made was that I have signs of weakness in the side affected by PD. She indicated this wasn't normal in early onset. Any comments? Phil Gesotti 47/1+ [log in to unmask] P.S. She had a really good physicians handbook on PD. I was reading it while waiting in her office. She told me it was a good book to which I responded that I had copied down the ISBN. She asked me why. "Was I an M.D.?" She told me that she had much better books that a patient could understand. Slam! Anyway, the book was actually good reading for tekies. It had a good block diagram showing control paths in the basil ganglia, neurotransmitters and plus and minus signs for neurotransmitter interaction. Funny how sensitive M.D.s can be sometimes.