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hi carol you wrote: >Thanks for the feedback on my hip and back pain. My doctor in Houston >( I was there in June) took me off CR and started me back on 25/100. >He also increased my daily dose from 8 to 12 mg. daily. while it has >stopped my "equilibrium" problems and has helped my "freezing" and dyskinetic >episodes it may be in part what is causing my problems. I am on Mirapex >(started this week by my neuro in Pittsburgh. She is at the same time >weaning me off of 3mg. daily dose of Permax. something in your sinemet dosage just jumped out at me: your doctor in houston switched you from sinemet CR to regular sinemet? if you had been taking 800 mg per day of sinemet controlled release i.e. 4 x 50/200 CR = 200mg carbidopa/800mg levodopa? since up to 30 percent of the CR med is lost or wasted in the body, then in reality you were only getting the benefit of 70 percent of the 800 mg CR = 560 mg and then your doctor increased the sinemet doseage from 800 to 1200 mg daily? i.e. 12 x 25/100 = 300g carbidopa/1200mg levodopa daily? so in effect, your useful sinemet intake has virtually doubled? from 560 to 1200 mg per day? from my lay-parkie, non-medico viewpoint this appears to be a mighty big jump in sinemet all in one go which could be causing you problems on its own regardless of the high carbidopa content i can't presume to advise you, carol, but from what you've told us, if i were in your shoes, or rather, in your wheelchair, with your pain problems, i would take a small step [wheelie] backwards and maybe get things settled down on the sinemet levels before getting too far into the permax/mirapex switch the only clear way to determine any cause and effect here would be to narrow the med changes down to one at a time would it be worth checking with your doctor in houston to verify the changes made in your sinemet intake? keep in touch! with love to you and yours your syber-sys janet [log in to unmask]