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LSTV Big versus Sinimet


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#1 BillBRNC

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Posted 13 February 2017 - 07:10 PM

Have any of you run into a neurologist who handles lots of Parkinson's opt for the physical therapy as the first line of treatment as opposed to Sinemet (assuming Sinemet is the appropriate drug, but it could be any of the Parkinson's drugs for purpose of this question)? This assumes the patient is having difficulty walking, fallen a few times, trip and stumbles, tremendous fatigue, and pain from stiff or cramped muscles, and other such good stuff. I would say severity isn't severe, but it is close to at least moderate I would guess. I just don't know the status of this LSTV Big thing within the neurological community. It obviously is popular within the PT community. Thanks.

#2 Daven

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Posted 13 February 2017 - 09:01 PM

Bill,

My MDS is the one who prescribed the BIG program for me. I've been on Carbidopa/Levodopa for several years and after procastinating on dong the BIG program for over a year, I finally completed the program this past December. I highly recommend doing both if that's what you need to improve the quality of your life. It's not BIG vs Sinemet but rather whatever it takes.

Dave
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#3 PatriotM

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Posted 14 February 2017 - 06:54 AM

The MDS that I see insists on two things: 

 

1. EXERCISE (including neuro rehab, BIG, Delay the Disease, etc)

2. living a normal life

 

He thinks PD meds should wait until really needed, especially for younger patients.


Diagnosed 9/2013

Not taking any PD meds (stopped taking Mirapex due to fatigue)

Using exercise to battle PD

Walk minimum of 12,000 steps a day which improves rigidity,balance, etc (everything but tremor)


#4 BillBRNC

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Posted 14 February 2017 - 07:42 AM

Well, I'm 66 so that seems young to me, but I don't know about others. The thing I've seen in the reading I've done is that there is a difference of opinion on this, and I don't know what it really means.

#5 Gardener

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Posted 14 February 2017 - 08:45 AM

Hi Bill,

 

I'm not sure I follow your question.  There isn't a difference of opinion on using Sinemet and doing physical therapy.  As Daven said, it's not an either/or.  Exercise and physical therapy is good at any age.  Sinemet therapy is sometimes reserved for later years with PD, especially with young onset PD.  Young onset is defined as 40 years and under however some doctors treat ages 40-50 as young onset.  66 would not be considered young onset.  Since you have Dementia with Lewy Bodies your medication treatment would likely differ from those with idiopathic PD and it would be important to follow your doctor's advice.  Wish you well, Gardener


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Gardener, female, 61, diagnosed at 55, 900mg Sinemet divided into 6 doses, plus 50/200 Sinemet ER at bedtime


#6 BillBRNC

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Posted 14 February 2017 - 08:53 AM

Gardener, thanks for the comments. I had actually wondered what younger onset meant with Parkinson's. With Alzheimer's, younger is below 65. With Lewy Body, I have no idea whether they even spit it up that way. My question was an either/or, but actually both at the same time. I know physical activity is very important for a lot of reasons, but particularly with Parkinsonian stuff.

#7 BillBRNC

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Posted 14 February 2017 - 05:11 PM

Well the neurologist started me on Sinemet low dose for a few weeks, then up it if everything ok. If everything ok, when we reach stable point then I'll start Big. He said we should reach the start for Big within a month probably.

#8 Gardener

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Posted 15 February 2017 - 06:34 AM

Bill,  That's great!  Hope you are feeling better soon.  Gardener


Gardener, female, 61, diagnosed at 55, 900mg Sinemet divided into 6 doses, plus 50/200 Sinemet ER at bedtime


#9 BillBRNC

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Posted 15 February 2017 - 08:38 PM

Yeah, I hope so too. Not to complain, but it would be nice for some good stuff to happen.




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