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I finally spoke to my mother's doctor today about her appointment yesterday. Briefly, here's her background: My mother Joyce (69) was diagnosed with PD 2/97 then rediagnosed with striatonigral degeneration (SND) 9/98. Her PD symptoms are mostly rigidity and slowness. Recently and suddenly her head started slumping and is now severely flexed (her chin touches her chest) -- her doctor (a leading movement disorder specialist in NYC hasn't seen such a severe slump). She's on Sinemet, Requip, Artane, Efforex. She's never had a terrific (i.e., pronounced) benefit from the drugs, but clearly feels worse (gets tremors mostly) when she tries to go off anything. From my conversation tonight with the doctor, this is what I've learned. My mother probably has PD (maybe SND, but the fact that she does feel a bit better with the drugs makes this less likely). However, it's an aggressive form of the disease, as she's between stages 3 and 4 and has been diagnosed only 2 years. IN any case, he's assured me that clinically SND and PD are the same (i.e., same treatment) and I shouldn't get so hung up on the exact disease as a result. Her spinal MRI shows some compression of the spine, but no fractures. The doctor thinks her head slump is probably a muscular/skeletal problem not related to PD and has recommended she see an orthopedist who specilizes in backs. So now she is traveling to another specialist. I have noticed how a doctor's approach to the disease affects me and my family. The doctor who insists that my mother has SND is also quick to dole out a prognosis (not so good). The current doctor suspends classifications (unless pressed, which I tend to do), leaving open the individuality of the course of this disease. And I am now beginning to see just how important this approach is. It also leaves room for hope without denial. Most important, I don't get the impression that my mother is being written off because of the rapid pace the disease is taking with her. Debbie White [log in to unmask]