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MR ROBERT A MARTONE wrote: > > 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 > ------------------------------------------------------------------------> ----------------------------- > 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, > > -- > [log in to unmask] > Kingwood, TXDear Bob & Nancy, The best of luck to Nancy and her courageous battle with PD. I have had pd 19 years now and the dskinesias, arthritis etc. have trigered hip and back pain for "no apparent reason". I don't think the doctors have figured this out yet but I understand Nancy's pain and wish you both the very best luck! we will be moving back to houston, in the year 2000 when my husband retires from USX. [log in to unmask]