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Phil, I like most of the others feel that medication should come first. The question is Is the Tasmar going to be sufficiently effective. I was in a similar place several years ago and entered an Entacapone study. It's benefits were mild to moderate (when I was on the open-label part of the study). BTW I would consider STN or Pallidal Stimulation before a Pallidotomy . But then I have a vested interest both emotional and (minimally) financial. I was so happy with the results I bought some stock in Medtronic Corp. the maker of the stimulator. The main advantage is that it is reversible as well as adjustable. But I clearly have a bias here. Charlie Philip Connors wrote: > Carol, my wife of almost 40 years, faces a very difficult decission and I > sollict your input. > I have been mostly, but not exclusively, lurking from the inception of this > List. I have learned more about PD than I ever wanted to know, but also many > useful things also as my wife, Carol's PD progressed. Again I ask for some > timely input. (ASAP as u will c below.) > Quick Background: Carol is 62, basically good health, X-cpt for... > She is a young onset, symptoms mid to late 40's. Always a very active, > driven person. We live in rural New England town, 3,500 popul. near > Worcester, but with no public transportation. She has her driver's license, > but has stopped driving. > > Her main problems are Freezing, OFF periods, and dyskinesia. We live in a > 125 year old Victorian 3 story house in the center of the town. > The most serious thing facing us is that Carol's neurologists suggested that > she see the MGH surgeon, Dr. Reese Cosgrove, and he strongly suggests a > pallidotomy. (It would be done in the Fall.) It will be her decision and it > is not clear or easy. (I ask that anyone who feels that they can contribute > or constructively kibitz to do so as we prepare for next TUESDAY's app't with > her neuro at Fallon HP.) > An interesting spin occurred when Carol & I visited my sleep apnea doctor, a > neuro, and when we were discussing things in my life that could cause stress > - Carol's situation, including the potential pallidotomy, came up. He asked > if we had considered Tasmar and when we said that we had and Carol had used > it, but her neuro had taken her off it when the liver damage fatalities had > come up. He said fine compared to another drug, but now we were comparing > the Tasmar risk (which has apparently not continued with many patients using > it under close liver function monitoring) to BRAIN SURGERY. He then backed > off and said that he did not want too interfere in some other DR's area, but > suggested that we rethink it and discuss it (the possibility of restarting > Tasmar) with Carol's local (15 years) neuro who we are seeing next week. -- ****************************************************************************************** Charles T. Meyer, M.D. Middleton (Madison), Wisconsin [log in to unmask] ******************************************************************************************