Dear Phil,
I have comments re your message below.
1.How do you function between 7pm and 7am
during which you don't take anything?
2.Aliza takes Sinemet CR 50/200 pills at four
hour intervals around the clock including the times you
mentioned at 7am,11am,3pm,and 7pm.Before going to sleep
at 11pm,she takes one and one around 3am depending upon
when she gets up.It works much better for her not to have
a long hiatus during the night.
3.We think that your pill instability can be improved by
taking your meds around the clock so that you provide
an approximately steady flow of dopamine to your brain.
4.We tried interleaving small doses of regular Sinemet with
the Sinemet CR during the third hour,but it didn't work for Aliza.
5.Aliza switched from regular Sinemet to CR since the regular
gave her dangerous drops in blood pressure which the CR
doesn't.
Gil Lieberman,CG for Aliza 75,dx 2/95
-----------------
Date: Sat, 24 Apr 1999 18:23:51 -0500
From: Phil Tompkins <[log in to unmask]>
Subject: Bad pill day
Ever have one of those bad pill days, when it takes hours
before your levodopa starts working? Here's what I mean:
(view with Courier font to make columns line up)
Good pill day schedule as per neurologist:
Sinemet CR Regular Sinemet Eldepryl Permax
50/200 25/100 5 mg .25
7 am 1 1 1 1
11 am 1 1/2 1 1/2
3 pm 1 1/2 - 1/2
7 pm 1 1/2 - -
Bad pill day, (or Where, oh where, has my Sinemet gone?):
8 am 1 1 1 1
OK, it's Saturday. The doses will be an hour later.
8:30 Breakfast - Low fat cereal with hot water instead of
milk.
9:30 ON. Pill(s) kick in.
11:30 OFF. Much earlier than expected. Did the CR start
working yet or not? Did it reach the small intestines
where it is absorbed? Need a snack to provide evidence.
noon Plain oat bran muffin to stimulate gastric activity.
12:30 ON again - Aha! That's the CR, just a bit late.
12:45 Too early for the 2nd Sinemets, so I take just the 11 am
Eldepryl and the Permax.
1:00 pm Lunch: Assorted cold salad appetizers (takeout) from a
nearby Turkish restaurant. Not really loaded with olive
oil, but some is present.
1:15 - Start afternoon nap. That's what Saturday's for.
2:50 OFF when I wake up.
3 1 CR, 1 regular Sinemet (2nd Sinemet dose of the day).
3:30 - 4:30 Various snacks and beverages to get the old innards
to move the pills out of the stomach.
5:30 ON.
And so it goes. Levodopa works well enough once it gets to where it
functions. The delivery mechanism stinks. Comments anyone?
Phil Tompkins
Hoboken NJ
Age 61/dx 1990
