Thursday, March 28, 2013

Benefit for

The voices of Parkinson's in movenent, the class for Parkinson's patients to maintain their voice by singing, is holding a fundraiser.  

5 à 7 le 9 avril
Admission $10
Concert, bar payant et bouchons
Griffintown Café
1378 rue Notre Dame ouest

Et vente de peintures
tous les bénéfices au profit des classes
de « Parkinson en mouvement »
(voir d'autres peintures et liste de prix à
'pandorasboxinthegardenofeden.blogspot.com')




The following paintings will be on show:


     Tree, 14x18 inches oil on canvas stretched , $300




 Tree, 18x24 inches acrylic on stretched canvas, $500




Gulls, 12x14 inches acrylic on paintboard, $340






Retreat, 10x14 inches watercolour on paper, $140






Sunset, watercolour on paper, 15 x 22 inches, $330

Saturday, March 16, 2013

Better control for Parkinson's symptoms


Dosing carbidopa/levodopa in later Parkinson's disease with motor fluctuations.

After the first five years with Parkinson's disease, motor fluctuations become common. There are no longer enough dopaminergic neurones remaining to store the dopamine from the levodopa doses, and you go from an “off” state to a “dyskinetic” state over and over during the day. You are either not moving because there is not enough dopamine, or you are moving all over the place and tipping yourself off balance from too much. The very short half life of levodopa is at fault.

Dr. Ahllskog in his book The Parkinson's Disease Treatment Book (2005, Oxford University Press) explains how to deal with this.
  1. Find the dose of levodopa that gets you motor improvement but not dyskinesia. (For some this is not possible because the two responses occur at the same dose.)
  2. Match the interval doses to the duration of the response. Then reduce the interval between the doses so that the effects overlap. Eg, if you expect to go “off” 3 hours after a dose, and it takes 30 minutes to kick in, you need to take the next dose after 2 1/2 hours. You can take as many doses as you need to to maintain the response.
  3. I found that the first dose of the day had to be a little higher, because the duration of response to that dose was very short. This is likely due to the fact that while sleeping you tolerate a lower level of dopamine, and so it takes a little more to saturate.
I ended up with a program of

7am 1 1/2 tabs
9:35 am 1 tab
12:10 pm 1 tab
2:45 pm 1 tab
5:20 pm 1 tab
7:55 pm 1 tab
1 tab at bedtime and when I wake in the night (usually after 3-5 hours).

And with that I am “on” all the time (well at least for 3 days)! I need to evaluate how I do when I am at the gym, since I may need an extra 1/2 to 1 tablet to prevent fluctuations after workouts. It is a miracle!

I have to add that at the same time I am adding a dopamine agonist, but I am still at a dose of that medication too small to be expected to make a difference.