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Excess Saliva, Hypotension and Dry Eyes

Excess Saliva Glycopyrrolate Hypotension Dry eyes

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#21 Dr. Okun

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Posted 30 October 2013 - 03:17 PM

I cannot really comment too specifically without seeing him.

 

You may ask about atropine drops in the mouth for drooling.

 

The BP medication in Parkinson's can be troublesome, so I would be cautious as you are.

 

Leaving the teeth in place could lead to infection if they are not healthy.  During the procedure as light of sedation as possible is the best bet not to worsen confusion.

 

I tend to stay away from Agonists in these complex cases.


Michael S. Okun, M.D.
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

#22 daddysgirl

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Posted 07 February 2014 - 02:24 AM

Hi, I wanted to update you on my dad's condition and get your advice on a couple of things.  My dad, who is now 90, has been off Sinemet since September.  He was diagnosed with atypical Parkinson's in 2005, but his doctor now suspects that he may also have Lewy Body Disease with dementia.  Since we took him off of the Sinemet due to frequent drops in his blood pressure, he has been doing well, considering his diagnosis.  His doctor wanted to give him Mirapex as a replacement for Sinemet, but per your advice and my research, I decided to monitor him instead and his doctor agreed.  I also started giving him coconut oil in September, which he takes 3X a day.  Since coming off the Sinemet and taking the coconut oil, he is more lucid and alert, and he rarely gets disoriented.  His walking has not gotten any worse, his pressure has stabilized and he is able to keep his head up more when sitting.  (We use a gait belt to assist him, as he cannot walk on his own.) Currently, he is taking one baby aspirin daily, Vit D and Centrum Silver multi-vitamins, and a 1/2 dose of Clonazepam at night which has really helped him with his night-time hallucinations.  As you may recall, his main problem is uncontrollable drooling and excess salivation.  To combat this problem, we give him Tussin (guanefesin) and his lung specialist recommended that we give him Atrovent via a nebulizer on an as needed basis to open his airways which gets clogged from thick mucus.  This treatment has been effective and the side effects have been minor.  His doctor also prescribed benztropine, which I gave him on a trial basis for two days and he tolerated it well, but we don't give it to him regularly because he has infected teeth and the dentist said if his mouth dries out too much that would make his infection worse.  His other main problem now is his vision.  He suffers from dry eyes, so we give him Systane every two hours.  (He has a lens implant in both eyes due to cataracts.) I have two questions for you: His eye doctor prescribed Tobradex when needed, but his directions for use has been inconsistent.  Initially, he told me to give it to him at bedtime for 10 days when his eyes get really inflamed, but I saw another eye specialist who told me to give it to him twice a day for only 3 to 4 days when his eyes are really flamed, what do you suggest?  My other question is, my dad has been on Aricept (10mg) since 2010, I don't really think it has helped him much.  Since he is doing so good cognitively, I was thinking about taking him off the Aricept.  I did discuss it with his doctor months ago, but I never did it because we were focused on all his other problems. Now that he is stabilized, I want to take him off of it and see how he does, what do you think?  And, can we just take him off of it or do we need to wean him off of it, if so, how should we wean him off if?  He takes only one Aricept a day.  As usual, I appreciate any assistance you can give him, as you and your team have been really helpful in the past.



#23 Dr. Okun

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Posted 08 February 2014 - 06:17 AM

Thanks for the comments.  In some cases Lewy Body disease and advancing age can lead to hypersensitivity to medications.  I am glad you and your doc are working together to find the best solution for your dad.  We generally follow the eye doctor's lead on eye drops.  For Aricept, in some cases of Lewy Body and PD it makes a huge difference so if you and your doc decide to wean you may want to do something very gentle in case you need to restore the medication back to previous levels (maybe every other day for a week; then every third day, etc.).  Usually if they worsen we go back to full dose.  This is a strategy you can discuss with your doc.


Michael S. Okun, M.D.
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

#24 miracleseeker

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Posted 08 February 2014 - 10:16 AM

I'm actually very interested about the coconut oil.  I've read stories of people claiming that it helps with brain functions.  How do I get this and does it taste bad?  I would like to try it out on my mom.  It's not a drug or a supplement so I don't think her doctor would object. 



#25 Dr. Okun

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Posted 08 February 2014 - 06:42 PM

I will post for you.  No great studies in PD on coconut oil and we are not recommending it, though it is likely safe.


Michael S. Okun, M.D.
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

#26 miracleseeker

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Posted 09 February 2014 - 09:14 AM

No I don't mean for PD but rather for dementia/alzheimers.

 



#27 Dr. Okun

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Posted 09 February 2014 - 04:09 PM

Our site is mostly focused on PD, but I am also not aware of any solid evidence from a large trial supporting coconut oil and AD.  I know there are some efforts getting under way.


Michael S. Okun, M.D.
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

#28 daddysgirl

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Posted 09 February 2014 - 05:49 PM

While there has not been any scientific study completed to my knowledge on the efficacy of coconut oil, there has been a lot of anecdotal evidence that it has really helped people with dementia and Alzheimer's. (I believe that a university in Florida was going to do a study, but I can't recall the name of the institution.) Like Dr. Okun said, it can't hurt. However, some people can get diarrhea.  Hence, I suggest you start out slowly. I started my dad out with 1 tablespoon of coconut oil daily for a month to make sure there were no side effects.  We put it in his cereal in the morning with a 1/2 teaspoon of cinnamon, which is suppose to help lower cholesterol and help with inflammation.  I increased his dose to 2 TBLS a day after a month.  And, now we give him 3 TBLS a day.  I would not suggest doing more than that.  We give it to him for breakfast, then mid-day; we put it in his Glucerna with a 1/2 teaspoon of cinnamon, and we put it in his soup at night w/o the cinnamon.  It can go in anything, but it does get clumpy in cold items, so you have to stir it good. You can get it at a health food store. I would suggest that you only use pure or virgin coconut oil.  It does have a funny after taste, but that does not bother my dad.  I spoke to one lady who told me that after six months of giving it to her month who has Alzheimer's, they were able to take her off her meds.  All I know is, my dad has been remarkably lucid since he has been taking the coconut oil. I hope this helps.  Also, check out this link: http://www.youtube.c...d&v=DVD7ZuCe3vY



#29 miracleseeker

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Posted 11 February 2014 - 12:38 PM

I gave my mom coconut milk with cereal before and she had diarrhea so I stopped but I will try your suggestion.  Thank you very much.  Sorry Dr Okun for straying off topic.

 

 



#30 Dr. Okun

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Posted 11 February 2014 - 01:40 PM

No apology necessary.


Michael S. Okun, M.D.
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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