It was a week ago today that our friend was admitted to the hospital
because of medication problems.
Today was the first day we have seen significant improvement.
Al and I arrived at the hospital about 2.45 and found our PWP and his
wife sitting in the lobby. He was in a wheelchair with a blanket around
him, but he looked better than I have seen him in about three weeks. The
'mask' had disappeared, his eyes were bright and his speech was very
clear. We chatted for a few minutes and then we went back to his room
because his next Sinemet was due at 3. His medications are still being
administered through the nose tube.
He got up from the wheelchair and into bed by himself, and was able to
lie in bed on his back with his knees bent, something he hasn't been
able to do for a couple of weeks.
When he was admitted, he was frozen most of the time.
Monday, there was no improvement...a most frustrating and frightening
day.
Tuesday, he was slightly improved with some reasonably good "on" time.
Amantadine was added that morning and it seemed to give him a
kick-start, and he was able to walk a short distance with the help of a
P.T. However, shortly after lunch he went "off" again and his
muscles and joints stiffened noticeably, and he didn't have any "on"
time for the rest of the day. His wife was able to contact the MDS, and
he had the Requip cut back by half and Ativan and amitriptyline were
added at bedtime. Whether it was a reaction to the amitriptyline or the
Ativan or both, we don't know, but he had a very bad night, and pulled
the nose tube and catheter out.
Wednesday and Thursday were about the same as Tuesday during the
daytime hours..."on" in the morning - "off" pretty much for the rest of
the day. However, at bedtime the amitriptyline and Ativan were replaced
with other drugs that he was used to taking. The nights were still bad.
He was disoriented and Thursday night he pulled the tubes out again.
Friday was a down day. His morning "on" wasn't as good as the previous
three days, and he was very discouraged. We all were, but we told him
there was bound to be a down day here and there.
Saturday was a little better, and his wife left the hospital early
(about 7, I believe) because he seemed to be settled in, and he had a
better night.
Back to today. It really seems that the Requip is the culprit. He had
been given Requip and Sinemet at 2, and his wife (who has been keeping
very good records) said that about an hour and a half after the Requip,
he freezes. Sinemet was given at 3, and as we sat there chatting, he
said, "I'm going..." Sure enough, 3.30 and he was "off." Ten minutes
later, he asked for Tylenol (his first for the day.) At 4 he was given
another Sinemet and he asked us to stay and see if the Sinemet would
bring him back "on." About fifteen or twenty minutes later, he dozed off
and slept for about fifteen minutes. When he woke up he was "on." When
we left the hospital he was lying on his side, looking quite
comfortable.
Also, after he woke up there was a slight bit of dyskinesia in his
hands. This is something that has puzzled me from the onset of this
situation. Considering the amount of levodopa going into his system,
there was no dyskinesia.
Tomorrow the MDS is supposed to be back from vacation so we are anxious
to hear what he has to say and where we go from here.
My heartfelt thanks go out to those of you who have helped me through
this difficult situation.
Judith
--
Judith Richards, London, Ontario, Canada
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