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On Tue 29 Dec, judith richards wrote: > Hello Brian, > I was hoping to hear from you. > I was so tired last night when I was trying to write that I could > hardly think, so to answer some of your questions.... > My friend is 57, and was diagnosed in 1991, so he hasn't been dealing > with PD nearly as long as you. Hello Judith, I'm sitting back and reviewing the situation of your friend, after a veritable flood of comments, to see if I can add any more. I felt that my PART 2 might be a bit of an anti-climax, but the fact is, its a very tricky business when you are trying to squeeze the last drops of juice out of the meds. I have seen the situation many times: the patient arriving at the 7 or 8 year point, when quite suddenly the tolerances become road blocks, what used to work suddenly starts to generate tremors, or (worse)-dyskinesia. I must confess that I did begin to wonder about MSA (Multi-System Atrophy) or Steele-Richardson (Shy Drager inthe USA ?) but the facts as we have them could still be the result of plain PD, especially if you mix in a stubborn patient who just wants to get on with his life. Most of us have learned that the time for your next tablet is just at the point where the previous dose is at its peak effectiveness. If you try to operate on an 'as required' basis, you can get into a wild roller-coaster ride (just like your friend). By the way, could it have been Apo-morphine which was injected , rather than Morphine? Apo-Morphine is not a narcotic, and is cleared as a dopamine agonist in the UK, and probably Canada. It's chief use is as a fast reacting drug, because it by-passes all the complex processes in the digestive system . The bad news is that its effective duration is about half an hour. There is an old saying - He who self-medicates has a fool for a doctor. This may be generally true, but I have proved to my satisfaction that in the case of PD, a properly-briefed PWP can operate in a way that a neurologist cannot hope to match, simply because only you know how it really feels. Regards, -- Brian Collins <[log in to unmask]>