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Too many surgeries?


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#1 Beau's Mom

Beau's Mom

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Posted 15 February 2012 - 11:52 AM

Hi Dr. Okun,

You may remember that in late December I fell and ended up with a proximal humerus fracture. I saw my ortho two days ago and he said that my fracture has healed well, but there is a place on my shoulder that needs to be shaved off due to a bone spur which is affecting my ability to achieve good range of motion. He suggested an MRI. I can't have MRI's because I have a device implanted in my back which keeps my left knee from hurting. However, most of the time it is off as I rarely need it anymore.


Would it be worth it to have the spinal stimulator removed so I can have MRIs instead of CT Scan with contrast to determine the exact problems in my shoulder? Is it likely that due to my PD I will be more likely to need MRI's in the future? Or is that one more unnecessary surgery?


Also, my sinemet dose was recently increased from one 25/100 4 times/day to 1&1/2 25/100 4 times/day. I have had almost constant nausea, burping and gas since them. My MDS lowered me to 1&1/2 2x/day and one 2x/day for two weeks with the intention of increasing it again, but it hasn't helped much. I know sinemet causes nausea but does it cause excess gas and burping as well? My insurance covers Zofran. Is that something I could take?

Thanks for your time and consideration.

I am not a human being trying to have a spiritual experience; I am a spiritual being having a (sometimes difficult) human experience.

 

First symptoms: right-hand tremor, constipation and restless arms 1978 (age 25). Depression and anxiety (non-motor symptoms) began in 1989 and worsened through the years. Last inpatient episode June 2013.

Diagnosed December, 2010 by a regular neurologist (age 57). After negative reactions to Requip, Mirapex and selegiline began Sinemet 25/100 3x/day. First MDS visit in Houston in February of 2011 was inconclusive. Second MDS visit at Baylor Fort Worth in May/June 2011 diagnosis changed to Parkinsonism, Sinemet stopped. Third MDS visit in August 2011 in WA State: received a confirmed diagnosis of idiopathic PD which had started on the right side and had now crossed to the left side as well. Restarted on Sinemet 25/100 4x/day. A short trial of Amantadine caused audio hallucinations in September 2011.

 

Current medications at age 62: Sinemet 25/100 ODT every 2.5 hours while awake (7/day). One Sinemet 25/100 CR between midnight and 4 AM. Trazodone 200 mg at bedtime, Fluvoxamine 300 mg at bedtime. Clonazepam 0.5 mg morning and afternoon, 1 mg at bedtime. Vit D3 2x/day, Calcium Carbonate Susp. 5 cc daily, Baclofen 10 mg 3x/day, Flonase two sprays 2x/day, Calcitonin-Salmon nasal spray once daily (for osteoporosis). Gel eye drops as needed throughout the day, Restasis Eye drops 2x/day, Nighttime eye ointment at bedtime. 02 2L per nasal cannula while asleep. Walker, electric wheelchair, moist and soft or pureed foods and 115 caregiver hours/month keep me sane.

 

All of the above subject to change based on progression, stress level, and dyskinesia. Whew! I'm glad I finally wrote that all out.


#2 Dr. Okun

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Posted 19 February 2012 - 04:55 PM

It usually does not cause burping and gas. It can cause nausea and the best treatment is to add carbidopa to each dose (an extra 50mg or more) or add domperidone to the drug regimen. You can ask your doc about this.

If you don't need the implantable device and you do need a MRI then you need to discuss with your doc the risks and benefits of device removal. Once you have the discussion you can weigh what is right for you.

Michael S. Okun, M.D.

Author of Amazon Kindle and Paperback 10 Breakthrough Therapies for Parkinson's Disease
Author of the Amazon Bestseller Parkinson's Treatment: 10 Secrets to a Happier Life
National Medical Director | NPF
UF Center for Movement Disorders & Neurorestoration
Read More about Dr. Okun at: http://movementdisor...hael-s-okun-md/
or Visit Parkinson's Disease treatment and research blogs at:
NPF's What's Hot in Parkinson's disease
or his parkinsonsecrets.com blog for treatment tips





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