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WOW, Ivan.... Interesting observation and question - I'm most eager to see the response. I'd like to hear what the medical community has to say about this, from "just plain neuros, to movement disorder specialists, to neurosurgeons who each seem to view the PWP, the disease, and the treatment in a somewhat different ways.... a slightly different perspective depending upon what service the physician provides for the Parkinson's patient. I know - from personal experience - that the Parkie who's had a pallidotomy is usually told, ORDERED, by their physician(s) to continue taking their Sinemet after they have the surgery, albeit many are able to significantly cut their daily intake down (as I was able to do, and 5 years post-pallidotomy, I continue to still take that same reduced dosage) <with a little tweaking now and then>. Let's hear it, medicos! Barb Mallut [log in to unmask] -----Original Message----- From: Ivan M Suzman <[log in to unmask]> To: [log in to unmask] <[log in to unmask]> Date: Monday, June 28, 1999 12:56 AM Subject: After DBS - WHY no SInemet needed?? >Hello folks. > >I am finding myself asking a fundamental PD question. > >Jane Ross said that she did NOT need Sinemet after her DBS surgery (see >below). >And Peter Dawkins mentions the identical situation as of a couple of days >ago (also see below). > >A pillar of our Temple of Wisdom is that we PWP's all need to REPLACE >missing dopamine that no longer is produced in the substantia nigra. >SInemet contains levodopa, that will convert to dopamine, once it has >reached the brain. > >When Jane or Peter need no SInemet, did the electro-magnetic current >replace dopamine? >I don't get it. Are the stimulated spots themselves the producers of >dopamine? > >Did Jane's or Peter's actual dopamine supply remain blocked, instead of >being non-existent, prior to DBS? Does DBS liberate stored dopamine that >is otherwise unavailable? > >Jane, I think you wrote that the battery died. Has you needed to return >to using SInemet afterwards? > >Thanks, > >Ivan :-! > > >On Sun, 27 Jun 1999 20:32:23 -0700 JaneRoss <[log in to unmask]> writes: >>My experience with sinemet was ... after the surgery I didn't need it >>any >>longer. Quit taking it. I actually feel better without it. Now I >>would >>like to get off Mirapex. >> >>>Dear Charles, >>>I noted you were on ropinerole which I understand will not be >>marketed >>>here.(Australia) I am at present titrating Mirapex which is just >>becoming >>>available here. It appears the latest edition of Brain has confirmed >>that >>>chronic stimulation of the subthalamic nucleus and levodopa produce >>>dystonia. Something I was pretty well was aware of through personal >>>experience and my visit to Professors Benabid and Pollack. I have not >>been >>>able to try and get rid of my Levodopa as none of the ergot agonists >>worked >>>for me. If its not an imposition could you tell me how long was your >>>titration period and if you were on ropinirole before your DBS. I >>am >>>currently working my way up by increasing my Mirapex by 0.25, 3 times >>a day >>>every five days and yesterday (Sunday) I actually had no levodopa on >>a dose >>>of 3/4 of a milligram of Mirapex three times a day. As I'm working >>and >>>driving today I had to take a very minimal dose of levodopa this >>morning The >>>results so far are stunning and certainly compliment the DBS surgery. >> At >>>last. >>> >>>Kind regards >>>Peter Dawkins >> >> >>jjjane >>http://www.geocities.com/soho/village/6263/pienet/people/hithros s.html > >^^^^^^ WARM GREETINGS FROM ^^^^^^^^^^^^ :-) > Ivan Suzman 49/39/36 [log in to unmask] :-) > Portland, Maine land of lighthouses 66 deg. F :-) >***************************************************************** *** >