-- [ From: Bob Martone * EMC.Ver #2.5.3 ] -- Nancy 52/22 continues to show progress on all fronts with the exception of the daily periodic freezing that occurs between sinemet doses. The freezing is also accompanied by some minor tremor in both arms. The tremor is a new phenomenon. The back surgery that fused some vertebrae between L1-5 and placed two titanium rods there to provide some much needed support to that area seems to be doing what was hoped. She is now enjoying far less pain and the pain medication that she does take alleviates most of the residual pain in her hips and lower back. Her posture has improved overall but this just started in the last couple of weeks. Whether she will stand completely erect again remains to be seen but the recent progress suggests there is reason for continued optimism. She has fallen a few times with black and blue marks to show for it and some soreness but nothing harmful to the surgical area and no damping of her enthusiasm to try to do more each day. Yesterday's fall cost us a table lamp and some more bruises but it was because she was down on her hands and knees doing some cleaning that she wanted to do. When she got up she lost her balance and crashed into the lamp. It shook me up much more than her. Next week we will visit the doctors office and have X-rays taken of her lower back to confirm that all is as it should be. At this point things look very good. With regard to Mirapex. She has been taking it now for just over three months. Daily doses of 1 mg pills are taken at 6 AM, noon, and 6 PM (3 mg total). From my perspective she is more alert, speaks more clearly in longer sentences, and shows more desire to do things. We recently bought some lake front property and she wanted to visit the property and fish. Since I also like to fish this was a good deal all around. We did catch some fish too. There is one new side effect that we attribute directly to the Mirapex and that is dizziness. It occurs so frequently that Nancy refers to it as her new state of being. We haven't changed any meds for about two months in order to give everything a chance to settle in before we do any more tweaking. Suggestions on what to do about the dizziness would be appreciated. Jim Cordy asked about the discontinuance of Permax. Nancy discontinued her Permax over about a two week period. There were no terrible consequences but it was a bumpy road as she titrated up the Mirapex ladder from .125 doses to 1.0 doses. To try to be more specific there were deeper off "frozen" periods and more problems with balance and some nausea. All of this improved with time. Current med levels follow: 3 Mirapex 1mg at 6 AM, noon and 6 PM 11 sinemet 10/100, 1 every 1 1/2 to 2 hours 2 effexor 1 in AM one in PM 2 amantadine 1 in AM and 1 in PM 1 clozaril at bed time Ativan for anxiety, propoxy, aspirin or tylenol for pain only as needed. Ativan is pretty in frequent and pain relief is needed maybe once or twice a day. Happy Thanksgiving, from the Martone's