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Barbara, Have you considered liquid Sinemet? It might smooth out the dose throughout the day. If not, what about a different medication regime? Has his neuro considered other meds? And finally, is he getting enough calcium and vitamin D to protect his bones when he falls (1200 mg calcium, 400 IUs vit D/day)? This can be a problem for PWP as the foods richest in both are also high in protein -- i.e., dairy products. I'd recommend fortified cereals, fortified orange juice, and fortified milk alternates, as well as supplements, unless his doctor knows of some reason why these would not be appropriate, or is satisfied with his current intake. My very best regards, Kathrynne Barbara Duffin-Bates wrote: > I do appreciate your thoughtful reply. No, I don't think Iain's > falling is due to loss of balance coming at the end of his "on" > times. The loss of balance always comes when he is most > "on". Even 1/2 a tablet causes severe diskensias and it is > when he is in this state that he will fall. I agree that he is > undermedicated but have been forced into this because of the > falling. Like I said, he NEVER falls when he is off. We did try > to add another half a tablet last week but he fell against the > piano and dislocated a finger. We cut the extra dose out. > > He is so uncomfortable when "on" that he himself prefers to be > undermedicated. He can't do very much, that is true, but he > can function in the house more or less. He can't do very > much when "on" either and the falling is dangerous. The > proverbial rock and a hard place. The falling has been a > problem for years and it is only recently that I wondered if the > medication, not the parkinson's, is the problem. That is why I > wondered if anyone else had experienced this phenomenon. > > Thanks again for your reply. Isn't this disease a puzzle? > > Barb Bates -- Kathrynne Holden, MS, RD "Nutrition you can live with!" Medical nutrition therapy http://www.nutritionucanlivewith.com/ Tel: 970-493-6532 // Fax: 970-493-6538