Dear list members,
My wife Nancy 52/22 is going to have back surgery on Wednesday to fuse
L3 to L4 and place a rod in her spine to support L2-L5. The hope is that
much of the back pain that she can not tolerate any more will be
alleviated. In addition her overall posture is expected to improve
dramatically by correcting the minor left leaning scoliosis that has
been exaggerated by the many years of fighting PD and dyskinesia. For
those that may remember Nancy had successful bilateral pallidotomies in
1995. Our hope is to further improve her quality of life by reducing the
back pain and correcting the postural deficit.
My question to the many wonderful list members is this. Since this is
not a PD surgery, we will not have a cast of PD experts around to make
sure all medications, anesthesia's etc. work in concert and don't create
unwanted consequences. However our neurologist will be consulting. I
have often seen on the list, references to drug interactions that should
be avoided during hospital stays. Naturally I can't find it now but I am
hopeful that some of you can reproduce such a list. Would those with
that info please come forward? We will be discussing this with the
Surgeon and anesthesiologist prior to surgery.
Nancy's current med schedule is listed below. You will note that she is
on Mirapex and has been for 2 weeks. I suspect there is very little info
on Mirapex and surgery so me may be the pioneers on this one. By the
way the Mirapex has had little or no adverse side effects and seems to
be producing benefits in areas of balance, speaking both in volume and
articulation, sleep, and general attitude including self reliance. Off
periods seem to be shorter by as much as 50% but their intensity has not
been reduced yet. Could this be an emerging MIRAcle Parkinson EXperience
. It's too soon to tell but it sure looks promising for Nancy. With
regard to the off times, apomorphine was denied to Nancy during the U.S
. trails because of the prior pallidotomy surgeries. Once it is approved
we plan to try that if the Mirapex doesn't help.
Note: Nancy has titrated from .375 mg of Mirapex per day to 112.5 mg per
day while titrating down on Permax from 3 x 1 mg (3 mg total) per day to
2 x .5 mg (1 mg total) per day. The plan is to be off Permax by
Tuesday. No changes in sinemet have been needed or tried yet because
there have been no big side effects. It is worth noting that since the
Pallidotomies Nancy has virtually no discernible dyskinesia in any drug
combination.
26-Aug-97 Monday
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4:30 AM 1 sinemet 10/100, if awake
6:00 AM 3 -125 Mirapex, 1 sinemet 10/100, 1 Loestril for estrogen
balancing
7:30 AM 1 sinemet 10/100, 1 Amantadine, 1 Effexor
9:00 AM 1 sinemet 10/100, 1/2 Permax
10:30 AM 1 sinemet 10/100,
12:00 PM 3 - 125 mirapex, 1 sinemet 10/100, 1000 mg Vitamin C, 150 mg
ferrous Furnate
1:30 PM 1 effexor, 1 amantadine, a Sinemet 10/100
3:00 PM 1/2 permax .5mg, 1 Sinemet 10/100,
4:30 PM 1 sinemet 10/100,
6:00 PM 3 mirapex 125 mg, 1 sinemet 10/100,
7:30 PM 1 sinemet 10/100,
9:00 PM 1/2 permax .5mg, 1 Sinemet 10/100,
10:30 PM 1 .25mg Clozaril, 1 Sinemet 10/100,
12:00 AM 1 sinemet 10/100, if awake
Notes for staff and garegivers
Amantadine/Symmetril is red, Ativan is white and has an "M"side 1 and a
321 side 2
Clozaril is white and is kept at the bedside, Effexor has five sides
Flexoril is round and yellow with 2 max as needed
Mirapex is white witha U on one side and a 2 on the other
Permax is pink and rectanular, Sinemet 10/100 is blue
Ultram is white and 50 mg max is 6 a day as needed
Thanks in advance for your help,
--
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Kingwood, TX
