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There has been much discussion both on this list and among neurologists about when to introduce levodopa, especially is the patient is under 50-55. Some neuros seem to take the delay levodopa plan and try agonists and other drugs alone. In some pwp, this therapy gives sufficient relief of pd symptoms. In other pwp, the introduction of levodopa alone or with agonists, segeline or other meds is more helpful in controlling pd symptoms. Ask your neuro why he wants to try Mirapex another 4 weeks? Is it because he thinks an increase in the daily dose may be needed to obtain theraputic dosage? Have you tried keeping a drug/symptom diary? This is a daily log that shows time of dose, time of meals(& type of food), and the pd symptoms as the day progresses. This can be very helpful to detect if the drugs are working or causing side effects, and can help show problems relating to timing of food intake and meds. Being proactive and by that I mean learning all you can about pd, pd meds and therapies is important for pwp. You must be sure you are doing an excellent job communicating your symptoms and your concerns to the nurse and to the neurologist. I try to not ever accuse the dr. of an error, choosing instead to indicate my disappointment that what has not seemed to work must be reexamined and a diff solution be tried. I also make a point of writing my ?? on paper with a copy for the nurse, one for the neuro and one for me to take notes as to the answers. In that note, I always thank the nurse, the doc and the university for the concern and help they demonstrate for me and my needs. As to giving up Mirapex, your neuro should know if he/she wants to try a diff agonist or if adding levodopa with the Mirapex is the plan that may help you function best and control the pd symptoms. Normally titrating slowly up and down is the plan I follow with my neuro's approval. Yes, PD meds are confusing and having a chronic illness can be depressing. BUT.......you have this group to help with the confusion and we even can lighten the day with a story or a joke on occasion or offlist. Good luck, Jeanette 49/47/44? ---------- From: Sherry Macredes <[log in to unmask]> To: [log in to unmask] Subject: Question on Mirapex Date: Monday, November 29, 1999 12:20 PM Dear Experts.. I am new to PD and need more info on meds to keep my neuro on his toes! I have been using Mirapex alone since dx in early Aug. After a long battle of increases I am now up to 4.5MG per day with no positive results. Now my neuro wants to keep me at this level for the next four weeks to be sure there is no improvement before trying something else. After reading the posts on the list over the last few weeks, it seems strange to me. How can I be sure it's really PD? Shouldn't I have been given some sinemet to see if I improved to be sure of dx? Don't most people need more than one medication, should I give up on Mirapex before adding something to it? It's all very confusing....not to mention depressing. Thanks for your input, Sherry 49/48/43