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Everything posted by ShopGuy

  1. Rasagiline and other drugs

    I take azilect (now generic)--no issues with balance, instability, or anything like that. And I do a fair amount of hiking. There's some reasons to think azilect will slow progression--in my case, symptom relief from azilect is modest (at best).
  2. daTscan side effects

    Do you have a g-i reaction to eating shellfish? If so, the iodine you had to drink before the scan may have caused an issue.
  3. 23 year old female worried about PD

    Depending on how you look at it, it isn't common for anyone to get PD. There's about a million people w/ PD in the US, out of a population of about 325 million--about 1/3 of 1% (1 in 325). PD is most prevalent among people 70 and older--even in that age group, only about 5% (1 in 20) have PD. As stump notes above, people younger than 50 when diagnosed (a frequent definition of young onset) are only about 5-10% of PD population. Put it this way--my GP has been in practice for decades, and has seen thousands and thousands of patients in his career. As far as I know, I'm the only patient with YOPD he's ever had. It's fair to say PD in people younger than 30 is very rare. When symptoms are consistent w/ anxiety (or bad reaction to meds, such as some antidepressants), that's a much more likely diagnosis. More to the point, in the extremely unlikely event you do have PD (and I agree with stump and Patriot--'twitching' really isn't a typical PD symptom) how would that affect your life right now? PD progresses slowly, typically very slowly in YOPD. People recently diagnosed can go years and years without significant disability. I was dx'd three years ago, and expect to be hiking, climbing the occasional mountain, and working to full retirement. Best advice would be: exercise more, eat better, start a retirement account, maybe purchase long-term care insurance (it's cheap when you're in your 20s). Try to relax and have some fun. All things that are good ideas, PD or not.
  4. Levodopa not really working

    Dopaminergic meds never did much for my tremor, and as others have indicated, that's not unusual. If need be, I can usually use relaxation methods, mental focus, and/or a bit of movement to temporarily stop the tremor. Your partner's probably figured out how to do the same. I understand this gets harder as PD progresses. In my view, it's easy to put too much emphasis on tremor as *the* PD symptom--IIRC, there's even some evidence tremor is a sign the brain is using alternate pathways to allow more or less normal movement. Certainly, tremor-dominant PD has better prognosis (slower progression) than other forms. I think most folks w/ PD (myself included) find stiffness, slowness (bradykinesia), and dystonia more troubling than tremor. Not to mention balance and gait issues, and non-motor symptoms. Is your partner's tremor currently causing impairment or disability? Or is the primary issue that it makes it visually obvious he has PD?
  5. Nilotinib trial recruiting

    https://foxtrialfinder.michaeljfox.org/trial/4999/ Phase IIa trial of Nilotinib is recruiting at a number of locations. This is the leukemia drug that caused quite a bit of excitement a year or two ago. My MDS is one of the study doctors. I don't qualify, as it appears this trial requires patients to be on levadopa at least 30 days prior, but others here might be interested.
  6. Just diagnosed at age 40

    Hi amy2beth and Kat2017, Dx'd at 46, 3 years ago. As others have said, PD progression is generally slow, with young onset typically even slower than later onset. We are fortunate, I believe, in that we have time to come to terms with our situation. Michael J. Fox has some things to say about acceptance I find helpful (and hopeful). PD's different for everyone, but in my case, there's not been much change in symptoms over the last three years. I work full time and, at this point, expect to continue until full retirement. I'm also doing some things now (travel, etc), rather than putting off what I may have less ability to do or enjoy later. Exercise is huge--with the best exercise being something you enjoy enough to keep doing. When the initial shock wears off, there are a lot of opportunities to get involved in PD research, from surveys, to genetics studies, to clinical trials. For me, being involved in research feels like taking an active role in my future, rather than passively waiting for (or fearing) what's to come. Best, David
  7. Update to meds

    Hi Stump, Thanks for the update. The word-finding issue sounds a bit troubling--interested to hear what the exercises are and how helpful you find them. I lose a few words from time to time--post-dx, it's hard not to wonder if it's a PD thing. Shortly after dx, I participated in a research study that included a battery of cognitive testing, two days worth IIRC. Was able to share results w/ my MDS; we figured it would be a good baseline for comparison down the road. Clinical trial I just completed included a short cognitive test about every visit--a couple of drawing tasks, some memory stuff, name-the-pictures like you mention, and the 'every noun starting with the letter _ in one minute' thing. Really hate that last one--I assume I did well enough at it, as my MDS never said otherwise, but feel pretty incompetent under that kind of pressure, regardless. Gets the tremor going, too. Re: DBS. It may be a few years off, but closed-loop machines seem very promising. Basically, the stimulation is continuously modified, in response to what is going on in the brain. Some details here (more specific to cortical stimulation than deep brain, but covers that, too): http://www.sciencedirect.com/science/article/pii/S1388245714000376#b0170
  8. Phase 1 Trial of New PD Treatment: My Experience

    Quick update: At the beginning of October, I had the last of my study visits for the BIIB054 Phase 1 clinical trial. Still have no idea if I received active drug or placebo. Overall, the experience was rewarding and worthwhile, and gave me a lot of insight into the process of getting drugs out of the lab and into clinical practice. I was impressed by the enthusiasm and hard work of everyone at the trial center, at every level. I never felt like an anonymous research subject, let alone guinea pig. For the time being, I've decided not to resume Neupro (dopamine agonist). I've been off it since March, with only slight increase of symptoms, all mild and manageable. So for now, I'll rely on Azilect and exercise as sole PD treatment. Phase 2 trials of BIIB054 have been announced and will be recruiting soon. For whatever reason, eligibility criteria have been tightened, and I won't qualify (3 years or less since dx, no current PD drugs, no previous treatment with levodopa or agonists longer than 30 days). For recently diagnosed PWP who may qualify for the Phase 2 trial, info is here: https://clinicaltrials.gov/ct2/show/study/NCT03318523#contacts The trial is somewhat invasive, with some uncomfortable procedures, and requires quite a time commitment. But immunotherapy drugs (like BIIB054) represent a truly new approach to treating PD, perhaps the first in a generation. With good recruitment for clinical trials, and continued successful results, it may only be a few years (less than five?) before we see one or more drugs that stop or radically slow PD progression on pharmacy shelves. As a side note, my MDS is also involved in Phase 2 testing of Nilotinib, the leukemia drug that made big news a year or so ago when a small Phase 1 open-label study showed remarkable results in late-stage PD patients. Since Nilo is already FDA-approved for leukemia, positive results for PD means the drug will be available to PWPs very quickly. For PWPs with the most advanced symptoms, including near immobility and serious cognitive issues, this could be huge. It's easy to be cynical and say a cure for PD has been 'right around the corner' for decades. 'Cure' is a strong word, and probably none of these drugs are that, but I believe there's more reason that ever to be hopeful. We're likely on the verge of major advances in PD treatment that haven't been seen since DBS was introduced 20 years ago. If all this pans out, I'm glad that, in whatever way, I had some small part in it. P.S. Lonnise, I just finished 'Being Mortal' the other week. Remarkable book. Thanks so much for the recommendation.
  9. Last Friday, I finished the five-day inpatient portion of a Phase 1 clinical trial for BIIB054, an immunotherapy treatment for PD being tested for the pharmaceutical company Biogen. Details of the trial (still recruiting at some locations, I believe) are here: https://clinicaltrials.gov/ct2/show/NCT02459886 Overall, the experience of participating in the trial has been very worthwhile. As the saying goes, there were stretches of boredom punctuated by brief moments of--okay, certainly not terror--but heightened anxiety. To prepare for the trial, I was required to stop some medications, and undergo blood and urine tests, an EKG, an MRI, and a DaTScan. Blood, urine, EKG, and MRI were to confirm good health (apart from PD); the DaTScan confirmed my dx. Cost of all testing (including DaTScan) was covered. Infusion of the study drug was done during a five-day, four-night inpatient stay in a research clinic. The study drug (or placebo) had already been administered in higher doses to 40 volunteers without PD, and a handful of volunteers with PD, with no significant side effects. My MDS is one of the study doctors--I felt the potential benefits for research and for myself outweighed the modest risks. I was well compensated for travel and time, and the catered meals were *far* better than hospital food. Day 1 was a battery of blood and urine panels, plus multiple EKGs, blood pressure readings lying down and standing up, MDS exams, and collection of cerebral spinal fluid via lumbar puncture (spinal tap). I was more than a little nervous about the spinal tap, but it turned out to be much less of a big deal than I imagined. Very little pain (just a little poke from the lidocaine injection, and a bit of pressure when the needle went it). After that, I was hooked up to radio telemetry to continuously monitor heart rate for the next 48, and spent the next several hours in the clinic's waiting room. By the evening, when we moved to the clinic annex where the bedrooms were located, I had a fair amount of discomfort in my lower back. This may have been a reaction to the lidocaine. I was given ibuprofen, which provided good relief, and was fine the next morning. There was another volunteer participating in the trial at the same time--that, plus books and internet, was a good distraction from a whole lot of sitting around waiting for the next blood draw, the next EKG, etc. Day 2 was infusion of the study drug (2/3 chance, two possible doses) or placebo (1/3 chance). Infusion was via IV and took about an hour. Some combination of fasting, lying flat on my back for an hour and who-knows-what caused pretty bad heartburn during the last 15 minutes of the the procedure. When I mentioned this, I was given immediate EKG and had blood pressure checked to rule out possible complications. For the rest of the day, we had regular blood draws to monitor the drug as it moved toward and crossed the blood-brain barrier. Day 3 was more of the same. The telemetry came off, and by afternoon, we were given the chance to take a shower and get out of the clinic for a few hours. I met up with a friend in the area and we went for a hike in a nearby park. Good to move the legs after 2 1/2 days sitting. Day 4 was another MRI in the morning, more routine blood draws and EKGs, plus another afternoon release (for good behavior?) On Day 5, when the results from the MRI came back, we had final MDS exams, and were released. There will be a series of followups over the next 16 weeks, including two more spinal taps and another MRI. I was told BIIB054 isn't expected to offer symptomatic benefits, but may (if it works, and if I got the active drug) slow progression by 4-5 times the rate without the drug. As I understand it, the drug is an antibody engineered to bind with the clumping form of alpha-synuclein, and clear it from the brain. The 'moonshot' (as my MDS put it), is that the drug will prevent the formation of Lewy bodies, and even reverse some disease progression. Needless to say, everyone at the clinic is very excited about this trial (and very appreciative of the patient volunteers). Given the lack of negative side effects, a Phase 2 trial is expected very soon (perhaps this fall), and it appears Phase 1 patients will also be eligible for Phase 2. I don't know if Phase 2 testing will be as invasive or require an inpatient stay. We often hear that new drugs take a very long time to pass human trials and get released to market--what I heard from clinic researchers was that with good recruitment and positive results, new drugs can be released quite quickly, perhaps 4 years or less from initial human testing. I feel fortunate to have an MDS committed to active research as well as top-notch patient care, and clinical research facilities located relatively close by. In fact, my MDS will be conducting Phase 2 trials of the drug Nilotinib soon. I don't know if I'll qualify, but it's exciting having cutting-edge stuff happening so close to home. Finally. a little soapbox: with a number of promising PD treatments in the pipeline, this is an excellent time for PWPs to get serious about research, by volunteering for trials (not for everyone, I know), and/or by contributing to organizations that support research (like the Fox Foundation), and advocating for increased support and funding for basic research through NIH and NSF. The basic research underlying all these new treatment has been twenty years or so in the making--too long a horizon to payback to expect private companies to do it alone.
  10. Not Diagnosed, However Need Advise

    I believe one of the reasons an MDS would hesitate to diagnose based on non-motor ("secondary") symptoms is that there are many conditions that can cause apathy, depression, cognitive issues, etc. Whereas bradykinesia plus rigidity, esp. in combination with resting tremor, is more specific to PD. Typically, PD-specific drugs like MAO-B inhibitors, dopamine agonists, and L-dopa don't do much for non-motor symptoms--you'd likely be prescribed antidepressants or anti-anxiety meds for those symptoms anyway. My own experience is that neither the dopamine agonist I was taking, or the MAO-B inhibitor I'm currently on have much effect on my tremor, or dystonia. Bradykinesia and rigidity responded well to the agonist, at the cost of a few mild but annoying side effects. I believe others here have had good tremor relief from dopaminergic meds, but it's kind of a crapshoot.
  11. Not Diagnosed, However Need Advise

    Hi Doubleup, I empathize with how troubling all the uncertainty can be. But if it were me, I would be very hesitant to pay out-of-pocket for a DaTscan. Clinical diagnoses by an MDS is very accurate--as accurate or more so than a DaTscan. For example, my PD symptoms are quite mild--a couple weeks ago, I participated in a presentation to first year med students about YOPD. Only about a third of the group was able to see that I had any symptoms, in spite of having just seen an MDS give me a neurological exam and being told (by both of us) exactly what to look for. Yet, three years earlier, when my symptoms were even less apparent, my MDS was able to diagnose PD in about 15 minutes. Someone who sees PD patients day-in, day-out, with all sorts of different symptoms, gets very good at spotting even early, mild PD. If your MDS isn't seeing it, that's worth really thinking about. I was offered a DaTscan at diagnoses, and my MDS said they would push the insurance to pay for it. I told him if he was sure of the diagnoses without the scan, that was good enough for me. As it happens, I had a DaTscan this summer as part of screening for a clinical trial (no cost to me)--the results clearly showed PD. The odds are very high you will spend a lot of money to get the scan, and still have no answers. If a PD specialist can't give you a clinical diagnoses at this point, it seems unlikely medical treatment for PD will do you much good either--there are NO proven disease-modifying medications available. Exercise and good diet are always good approaches, PD or not. So is financial planning, esp. as PD can mean earlier retirement than planned. If it were me, I'd take the money I was going to spend on DaTscan and put it in my 401k.
  12. For the past couple months I've been trying to swim regularly as part of my exercise program. Started out with the Master's Swim program my wife does but 5 am starts didn't work for me, so now I swim laps on my own during my lunch hour, two days a week. The problem is, my legs sink. Nothing I've tried seems to fix it. As swimmers know, sinky legs=lots of drag, and I can't go more than 50 yards without having to stop for a rest. Using a pull buoy, I can easily go 3 times that far before a break, and the swimming is actually enjoyable, rather than frustrating. When kicking, it often feels like my legs aren't working quite right, leading me to wonder if the increasing stiffness in my left leg as my symptoms progress isn't part of the problem. On the other hand, days I don't swim I try to get in a 4-5 mile walk, and stiffness hasn't seemed to affect that at all. Any SWPs (Swimmers With Parkinson's) out there who can provide advice? Do I just need more time to develop better swimming technique ( this is what my wife suspects) or can I expect improvement when I start PD meds (something that is looking like sooner rather than later in any event)? --David
  13. Hi Otolorin, I think I took isradipine for a little over a year. No symptomatic benefit, as far as I could tell, but wasn't expecting any--if it works, it's only expected to slow progression. Cost to me, after insurance, was $25 for three month's supply. $250, if I had to pay full price. My MDS tells me my progression is remarkably slow. I'm in very good health apart from PD, exercise regularly, and have taken Azilect continuously for the last two years. Maybe some or all of those things have helped. My blood urate levels naturally test high-normal--as high as the target levels in the current phase 3 trial for inosine. I was also dx'd very early on, in terms of symptoms, and am left-side tremor-dominant, and young(ish) onset--all associated with slower progression. Maybe I'm just lucky (or as lucky as it gets, having an incurable progressive disease). When I finish the clinical trial I'm involved with, I intend to start back on isradipine, and take it until results from the isradipine trial in a couple years. If results are negative, I'll stop. If positive, obviously I'll continue.
  14. Out of curiosity, I used my insurance company's online price checker to see what taking exenatide or nilotinib off-label would cost me. Just to be clear, even if I could afford to, I have NO intention of asking my doctor to prescribe either drug off-label. IF insurance covered it, Byetta (daily injection) would cost $2.50/day. Bydureon (weekly injection) would cost more than $10/day. Until recently, I was taking isradipine off-label (generic DynaCirc, which miracleseeker mentions above) and my insurance covered it with no questions. But isradipine is a cheap generic for a common condition (high blood pressure). For what it's worth, I don't have especially high blood pressure, and had no noticeable side effects from isradipine, but I don't have orthostatic hypotension either. If I did, I doubt my MDS would have prescribed isradipine. Isradipine is in Phase 3 trials for PD, and has been shown safe for PD patients in Phase 1 and 2 trials. But since I don't have Type 2 diabetes or cancer, I'm pretty sure my insurance wouldn't cover exentatide or nilotinib. Cash price for exenatide (either Byetta or Bydureon) would be about $600/month. Maybe doable, if my wife and I made a lot of financial sacrifices. Nilotinib (Tasigna) would be more than $12,000 for a four month supply, taking the lowest dosage studied for PD (150mg/day). Simply not possible. Good news, as I see it: clinical trials for both drugs are moving forward rapidly. Because both drugs are already approved for other conditions, IF (big 'if') either passes Phase 3 trials, they will be available on-label for PD shortly after--perhaps as little as 2-3 years from now. Of course, chances are neither drug will live up to the initial hype--another reason not to jump in w/ off-label use.. Two or three years from now is obviously too late for some, including my dad, who died from PD-related complications in February. But if exenatide really does what it appears to do--not only halt progression, but reverse it--it won't be too late for many more of us, including folks with quite advanced PD. I'm content to wait and see how clinical trials play out. I've checked and I won't qualify for the phase 2 nilotinib trial (my MDS is one of the researchers). I do plan to continue with an upcoming phase 2 trial of the drug testing I'm currently involved in. It's worth noting, the delay getting most promising drugs through clinical trials is difficulty finding enough volunteers for those trials. When possible, I'd rather put my time into that when, rather than trying to get my doctor to prescribe me super expensive, barely-tested drugs off-label.
  15. LIke others, I was pretty skeptical of WBV's intentions. But he's offered full disclosure, hasn't posted or linked to any marketing or advertising content, and has stayed anonymous so that none of us could patronize his business, even if we wanted to do. As long as that continues, I'll take his statement about his goals at face value. The video he links above seems clear and reasonable. With regard to specific claims about Whole Body Vibration, I'm still skeptical, but curious. The site Science-Based Medicine is a favorite of mine--here's what they have to say: https://sciencebasedmedicine.org/whole-body-vibration-therapy/ (Author is Dr. Steven Novella, a neurologist at Yale University School of Medicine). Short version: it's plausible that whole body vibration *could* work, but that it offers specific benefits for particular conditions hasn't been demonstrated in a rigorous way. Studies with more controls show little to no positive result for whole body vibration. Usually, that's not promising. It isn't crazy to think vibration might benefit some specific Parkinson's symptoms for some people (balance and gait, say)--it would be very odd if it improved all symptoms for many people (after all, no other treatment does). The abstract WBV posted on a separate thread is intriguing, but I'm underwhelmed by a study with just 15 people, a 6 week intervention period, and no control groups whatever. Conclusions seem pretty far in front of the evidence. No indication whether the abstract is from a paper delivered at a conference, a poster presentation, or a peer-reviewed paper published in a journal. Still, I'll read the other two studies he's promised when he posts them.
  16. NAUSEA ad nauseum?

    I had pretty frequent nausea from Neupro. Anything with strong ginger helped--preserved (with sugar), pickled as Linda says, good strong ginger ale or ginger beer. But then, I like ginger.

    No stem cell therapy for PD has passed rigorous clinical trials, and so far, trials of stem cells for PD have been underwhelming. The notion that for-profit clinics, in business for a few years, are achieving amazing results while legitimate researchers with decades of experience are not, makes no sense. Offering unproven stem cell therapies outside the context of a legitimate clinical trial, without full disclosure and obtaining informed consent (which is what all these so-called clinics are doing, regardless of their claims), is unethical, by any ordinary definition of the word. Charging many thousands of dollars for unproven, potentially dangerous treatments of dubious benefit is even worse. And, yes, people have been very badly injured by stem cell clinics: https://www.nytimes.com/2017/03/15/health/eyes-stem-cells-injections.html These operations are a scourge. They trade on people's fears, and victimize the vulnerable. Any doctor who profits from this work violates their Hippocratic oath, at the very least. Plenty of them deserve to be jailed for fraud and reckless endangerment.
  18. newly diagnosed outdoor active female

    Years ago, a friend and I spent two weeks hiking a stretch of the AT along the Blue Ridge--ended at Buena Vista, VA if I remember right. Beautiful country, but I don't miss the heat and humidity, or the overloaded pack I was carrying. Started doing the ultralight backpacking thing a few years before PD dx. Getting pack weight down was a big help even w/o PD--I expect more benefits as things progress. Sleeping on the ground isn't as easy as it used to be, but a thick insulated air mattress helps. The Pyrenees sound fantastic--my wife and I are hoping for Finland sometime in the near future, and I'd also love to go back to Iceland for an extended stay in the East Fjords. And this summer/fall may finally be the year we climb Mt. Adams (WA State), instead of just talking about it... My MDS is one of the study doctors for the inosine trial: https://clinicaltrials.gov/ct2/show/NCT02642393. Trial uses the dietary supplement inosine to raise blood rate levels. Urate within a certain range is associated w/ slower progression. My urate levels are already too high to qualify for that study (a good thing, I'm told). My understanding is, using inosine needs to be carefully monitored, as urate levels that go too high can cause gout. I was taking isradipine off-label until recently (see signature) and will resume in October. Had already started dopaminergic meds, so didn't qualify for that trial: https://clinicaltrials.gov/ct2/show/NCT02168842 Off-label isradipine use was with MDS guidance and consent. I've had no noticeable side effects, but others have (mostly mild edema). Searching for SURE-PD III (inosine trial) or STEADY-PD (isradipine trial) should be a good way to keep up to date.
  19. newly diagnosed outdoor active female

    Hi Hiker, Rates of progression vary widely. I'm starting my fourth year post-diagnosis, and have noticed very little (if any) decline in physical abilities. My MDS considers my progression very slow. Having said that, I was dx'd quite early, with just a few mild symptoms I probably could have ignored Like you, I'm active outdoors (hiking, backpacking, skiing, etc). I also have a job that keeps me physically active. Some of my symptoms are similar to yours--Neupro (a dopamine agonist) restored arm swing, and got rid of that draggy foot feeling, but also caused frequent nausea and afternoon sleepiness. These are mild side effects relative to what some experience with agonists, but still annoying. I haven't decided yet if I'll start taking it again, when the clinical trial I'm in concludes this October. As others have said, exercise is a great way to try to slow progression. You might want to keep an eye on Phase 3 trials of isradipine and inosine--two promising approaches for slowing progression that will be available immediately for that purpose if trials are successful. PD dx can be a shock, but also an incentive to focus on the present, and quit putting off plans for some future time (a future that may not happen, with or without PD). Last spring, my wife and I climbed our first Cascade volcano. Summer included multiple backpacking trips. Last fall, we went to Iceland for two weeks of hiking (including glacier hiking) and sightseeing--a trip we'd talked about for years. I did a three day mountaineering course on Mt. Rainier, which I'd like to repeat this coming spring under more challenging conditions. Based on my experience so far, and barring significant advances in treatment, I expect to keep doing this kind of stuff for another 5-10 years. Granted, pre-dx, I wouldn't have contemplated giving up intensive outdoor activity at 55 or 60 years old, and granted, being fortunate enough to have slowly progressing PD is not as fortunate as not having PD at all. But things are as they are.
  20. Lonnise: Thanks for recommending the Atul Gawande book. Just ordered it, and looking forward to reading. I'm afraid I'm on the wrong side of the country to return the favor w/ an MDS recommendation, but it sounds like you've already got a few good ones. Best, David
  21. Follow-up to Dancing Bear's cautions re: Promethease. My understanding is Promethease is completely automated: the analysis just matched your results from 23andMe (or other testing service) with info in the Promethease database. Some info is more reliable or relevant that other info, depending on the size of the study for that particular gene SNP, whether or not the study was ever replicated, etc. Promethease tries to rate the reliability and relevance of info about particular mutations with a number they call 'magnitude' which starts at 0 ('boring') and goes up. But the magnitude score is crowd-sourced, so has issues. It's useful to consider what percentage of the population has a 'bad' mutation, as well. For example, my Promethease report shows I have a SNP mutation (rs1333049(C;G)) associated with 1.5X increased risk of coronary artery disease. But 50.4% of the population has the same mutation, meaning more people than not have the same increased risk. Since my annual physicals show no other risk factors for CAD, I don't worry much about it. Also, testing services like 23andMe use an 'in-house' code name for some SNPs, which doesn't match the name of the SNP used in scientific literature. For example, 23andMe apparently uses code names for some of the SNPs on the BRCA genes where mutations are associated with increased breast cancer risk. Promethease tries to match 23andMe code names with names in the literature, but there's some guesswork involved and mistakes happen. Otolorin--thanks for the comment. My father died in February from PD-related complications, but did well while alive coping with his reduced physical abilities--fortunately, never any significant cognitive issues. My sister seems to be responding well to C/L. It was a struggle for her to find out what was going on and get a dx, and I hope she has a nice long honeymoon period with the drugs to make up for some of that.
  22. Phase 1 Trial of New PD Treatment: My Experience

    Hi Lonnise, Perhaps my signature is confusing--as far as I know, I have NO genetic markers associated w/ PD, and neither do my family members dx'd w/ PD. Here's part of another post I wrote that may clarify: Most people with PD *don't* have LRRK2 or GBA mutations, or any other mutations strongly linked to familial PD. My dad had PD, and my sister was recently diagnosed. That might suggest a genetic cause, but we've have also lived in similar environments, associated with somewhat higher risk. And the specifics of the disease were somewhat different for us--my dad was diagnosed in his late 60s, tremor dominate, relatively fast initial progression (very typical PD profile). My sister has no tremor, but debilitating postural instability, and gait issues. Symptoms starting ~55 y.o., undiagnosed for 4-5 years until she went to an MDS. I was diagnosed at 46, tremor dominate, very slow progression to date. Although my dad never had genetic testing, and I don't believe my sister has had any testing yet, I would be very surprised if either had LRRK2 or GBA mutations. Re: sub-categorizing. My guess is we're still quite a way from treatments tailored to specific PD subtypes, since research into what constitutes subtypes and and the different causes is still at an early stage. I try not to focus much on why I (in particular) wound up w/ PD. First, because there's likely no clear answer or single cause. Second, because for me it's a little too close to a 'why me?' kind of question, and too much 'why me?' seems likely to lead to dark places.
  23. When I used Promethease, the cost was $5. No LRRK2 or GBA mutations associated w/ increased PD risk. Same results with genetic screening for Parkinson's Progression Marker Initiative (i.e., I didn't qualify for the study). Thing is, most people with PD *don't* have LRRK2 or GBA mutations, or any other mutations strongly linked to familial PD. My dad had PD, and my sister was recently diagnosed. That might suggest a genetic cause, but we've have also lived in similar environments, associated with somewhat higher risk. And the specifics of the disease were somewhat different for us--my dad was diagnosed in his late 60s, tremor dominate, relatively fast initial progression (very typical PD profile). My sister has no tremor, but debilitating postural instability, and gait issues. Symptoms starting ~55 y.o., undiagnosed for 4-5 years until she went to an MDS. I was diagnosed at 46, tremor dominate, very slow progression to date. Although my dad never had genetic testing, and I don't believe my sister has had any testing yet, I would be very surprised if either had LRRK2 or GBA mutations. It's a weird disease (or diseases).
  24. Phase 1 Trial of New PD Treatment: My Experience

    Had the second spinal tap this past Tuesday (along with blood draw and ECG). Patriot, with regard to side effects: the consent document is 22 pp long, and goes into detail about known side effects from DaTScan, MRI, lumbar puncture, blood draws, etc (all minor). Regarding the study drug, the document states that since this is one of the first times the drug has been used in humans, "possible serious side effects are not known." In addition, the document makes it clear that BIIB054 has NOT been tested for increased cancer risk, or interactions with other medications. I'm not a doctor or medical researcher, but my understanding is increased cancer risk is not expected from immunotherapy (since the immune system often plays a role in preventing cancers). Cancer risk *is* a concern with stem cell therapies. Sadly, some unproven, unregulated--not to mention very expensive--stem cell 'cures' have caused cancers. It's tragic that desperate people were suckered into paying tens of thousands of dollars for a fake cure that caused real cancer. Of course, 'cancer' isn't a single disease. I think even slightly increased risk of a lethal, incurable disease like lung or pancreatic cancer would be a big deal. But maybe increased risk of less serious, curable cancers might be worth it. My dad was diagnosed and treated for prostate cancer at about the same time he was dx'd with PD. The prostate cancer never came back, or caused any significant problems for the rest of his life (15+ years). But PD disabled him physically, then complications from it killed him. Anyway, none of this seems applicable to immunotherapy. As it was explained to me, immunotherapy is basically one of two approaches: active, where the patient's immune system is stimulated to produce antibodies its own; and passive, where antibodies produced in a lab are injected in the patient. BIIB054 is the second type--passive. In some Alzheimer's trials, early active immunotherapy approaches caused runaway inflammation and killed patients. This has made researchers very cautious about active approaches, although there is an active immunotherapy treatment for PD that has advanced to Phase 2, and thus passed Phase 1 safety testing. The advantage of active immunotherapy is that only a few treatments would be necessary, after which the body's immune system would be capable of clearing alpha-synuclein on its own. Passive approaches are considered safer in principle, I believe. But it seems more frequent treatment is necessary, since the immune system doesn't actually make the antibodies. As an aside: the injection procedure I went through was pretty clunky--an hour lying down with an IV. If that had to be repeated say, weekly, I doubt it would be worth it to anyone without advanced PD. But I really have no idea how or how often BIIB054 will be administered if it becomes an approved treatment. When I talked to my doctor last Tuesday, he said he was surprised none of the PD patients he has enrolled and treated (four so far) experienced significant headache as a side effect of the study drug. He expected it, as a consequence of minor inflammation of brain and spinal tissues. I suppose that could mean any number of things, including that BIIB054 is safe, but not particularly effective.
  25. Anyone Else in the PPMI study?

    For what it's worth, I'm currently in a study that requires three spinal taps in a single month. That was pretty much my major anxiety about participating. I've had two of the spinal taps so far--nothing close to as bad as I expected. A few pokes from the lidocaine injections, then some pressure (no pain) when the needle is inserted. No spinal headache after (none of the other patients my doctor is working with have had spinal headaches either). Some moderate low back pain after the first procedure, that resolved with ibuprofen. Insertion point a little tender for several days after. Not sure about radiation exposure--is that from the DaTScan? If that's all, I'd say the risk there is vanishingly small. Many of us here have had DaTScan--thyroid is flooded by drinking a solution of non-radioactive iodine before the DaT injection, which prevents absorption of the radioactive iodine tracer. The iodine tastes pretty bad, and the hour-long scan is boring, but I actually preferred it to MRI (less noise and confinement).