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BillBRNC

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BillBRNC last won the day on November 13 2017

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About BillBRNC

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  1. BillBRNC

    Alternatives To Sinemet

    Dr. Okun, thank you for your thoughts on this. Bill.
  2. BillBRNC

    Dropping Things

    Gardener, thanks for reply. I don't really know what to call what my hands are doing right before I drop something. They aren't shaking, but my hands and sometimes my whole body seems to be on a hair trigger vibrating from the inside, and then all of a sudden I have what I guess could be called a startle type reaction in my hands, and sometime my whole body. I do not know what this is called or if it is Parkinson, as opposed to autonomic nervous system dysfunction from my Lewy Body Dementia. I have had to reduce Sinemet due to it aggravating my orthostatic hypotension. When I found a dosage that permitted my OH to rarely get worse than 80/60, I found that much of my Parkinson movement issues came back into play. I have appointment with MDS doctor in a month to find out if there are any alternative Parkinson meds that can do what my former dosage of Sinemet did without aggravating my low blood pressure problem. But I just think the dropping things is Parkinson, but I don't know. Thanks.
  3. BillBRNC

    Dropping Things

    I have the pill rolling thing with my hands, and I feel shaky and off balance a lot of the time. My question is whether dropping things I pick up is related to this disease. I assume it is, but it is not like my hands are shaking, because they only seem to have a very minimal shiver near the end of the day. Thanks.
  4. BillBRNC

    Alternatives To Sinemet

    Dr. Okun, I seem to keep coming back to you with more questions, and I am sorry to bother you. The question being considered by my neurologist and cardiologist is this: Sinemet provided very good relief from my Parkinson symptoms. But the Sinemet also made my cognitive issues from Lewy Body Dementia worse. We ultimately found that by taking CR rather than fast acting solved the acute aggravation of my non-Parkinson symptoms from Lewy Body Dementia. And that has worked well over time for me. Then along the way the autonomic dysfunction associated with LBD became very significant in that the orthostatic hypotension got rediculous, with very low BP reading upon standing up, sometimes in the 65/45 range. So my cardiologist approved the reduction and ultimate elimination of several heart failure medications I was taking that were intended to lower my blood pressure. One final cardiac medication, Coreg, had the dosage lowered to almost sub-therapeutic, and the Coreg is the biggie for lowing BP, but it is also the biggie for me staying our of heart failure. All the reductions of cardiac medications didn't solve the problem. So, the Sinemet was slowly reduced until I got my OH blood pressure drops to fall more into the 80/65 range that I could handle reasonably well. Unfortunately, the Sinemet got reduced so much that a significant part of my Parkinson symptoms returned. I can live OK with some of the symptoms, but the pain from muscles and joints is really rather significant. And pain medication at reasonable levels doesn't seem to provide any relief. So the question now is whether there is an alternative to Sinemet that can take care off my Parkinson issues as well as the Sinemet took care of them before we cut the dosage so low. In looking at the alternatives to Sinemet, we found that the alternatives specially listed orthostatic hypotension as a significant issue. I have reached the point of not really getting excited about making changes anymore in my medications, for all kinds of reasons. So, I don't want to go into a trial and error search for a alternative medication for Sinemet unless there is a very good chance that the new medication would not cause the same problems with OH and low blood pressure. Also, I noted the alternative medications also listed a number of cardiac function issues, and my heart failure is stable now but is unlikely to stay that way if a new medication were to introduce an additional cardiac issue other than OH. Dr. Okun, are there any good option with other Parkinson medications to manage my Parkinson problems without also making my OH worse? Oh, I think I probably questioned you about each of the steps we have taken before I took them per my local doctors, and you have been very helpful in all of those. Thanks very much. Bill.
  5. BillBRNC

    Startle Reflex

    I have this really really big time, but I also have Lewy Body Dementia. I have never viewed this as a result of taking Sinemet, since I had it before taking Sinement, but not as bad as now. I think it comes from the non-Parkinson stuff, or maybe from Exelon or depression med or whatever I can't think right now. If someone touches me when I don't expect it, I can react every agressively. Even when I know the touch is coming like from my wife coming over for to just touch my shoulder or something, I still jump. I have asked her not to touch me unless I say it is ok, but that is hard for anyone to remember. One time while checking into a hotel, I turned around to my wife and almost hit her in the face with a fist. Scared the tar out of me, her, and lady behind the desk and the people behind me in line. Very unpleasant scene all around. Needless to say I had never before hit my wife or even acted agressively towards her no matter what. I don't think I would ever hit her, but I do worry about slugging someone out in public, particularly if in a group of people. So much so that I simply don't get into group setting unless I am well outside the outer edge of the group. People think it is weird, but they just don't know. Good luck.
  6. BillBRNC

    sleep apnea and cognative decline in pd

    I have Lewy Body Dementia. And myoclonic jerking is something that folks with LBD often get. It consists mostly of involuntary jerking of arms and/leg and/or body core shortly after bedtime. It also can occur at any other time of the day, but it is most frequently seen while in bed. I am no doctor, so take advice from your doctor. The jerking is almost like putting your fingers in a wall socket and getting a good jolt. That what it feels like to me anyway. They come and go, so no a constant thing. I always assumed that Parkinson people got them too, but I don't know about that. I have fairly full blown Parkinson crap along with the Lewy crap. But Sinemet and PT has resolved a large part of my Parkinson stuff.
  7. BillBRNC

    Parkinson's vs. LBD Diagnosis

    I have Lewy Body Dementia. I got diagnosed based on cognitive symptoms, hallucinations, and history ,neuro-psych testing, and FDG Pet Scan. I did not have any Parkinson symptoms at the time. About 6 months later, I go hit will all the Parkinson stuff. PT and Sinemet helped me with a lot of my Parkinson troubles, but not all by any means. To your question, Yes, it is possible to have a normal FDG Pet and still have very early LBD. i would say if many of your symptoms are strictly Lewy Body Dementia symptoms, then I would be sure to have a complete work up at a major medical center's memeory assessment clinic to have your best probability of getting an accurate diagnosis. By way, a DAT scan is also used now to help diagnose LBD. I didn't have one and know very little about the DAT Scan. I do know that a positvie DAT scan in a LBD work-up is considered almost as strong as a positive FDG Pet SAcn. Bottom line, though, you should take your medical advice and opinions from your doctor and not from a message board. If you are seeing a Parkinson only type doctor, you might want to go even more to a memeory assessment clinic. Good luck, because you sure as hell don't want to have LBD. Parkinson's is bad enough to ruin a good day.
  8. BillBRNC

    Reduced Sinemet & Increased Problems

    Thanks Dr. Okun. On this past Friday, we cut down a tad on Sinemet by cutting one of the CR pills in half. I really haven't noticed anything yet. Also starting on Friday, I have cut coreg by 50% on way to 0. My cardio believes that it is more important to keep my blood pressure higher since I've had a goodly number of reading in the zone of 65/50, which as you know isn't good at all, but that is what we are dealing with right now. Most of the time, I think the BP is closer to low normal, but I keep having these plunge reading. Oddly, I don't really feel worse at 65/50 than I do at say 100/68 or so. Can't figure that out, but cardio is pondering it. He doesn't want to use the BP pills that are designed to push of blood pressure if there is any way to avoid it due to heart failure and other issues that worry him. He knows his stuff, so I trust him on all cardio issues, and many others too. Anyway, getting Sinemet down as low as possible is also what we want, but I don't see any way to go any lower. Once all this done, my personal belief is that nothing will have changed with regard to plunging BP issue. I now believe in my mind that nothing will help it because it is just something that can't be fixed with my autonomic dysfunction from Lewy Bodies Dementia. I hope I am wrong. But if I find myself in the same place a couple of weeks after we do all these changes, I will talk with cardio and neuro to see about adding back some of the reduced Sinemet, because a lot of my symptoms are coming back in not a good way. Thanks again for your help. Bill.
  9. Dr. Okun, I have been going back and forth with my doctors of various kinds to try to keep my blood pressure from tanking all the time. Part of process involves significantly reducing my Sinemet, actually cut in half prior dosage, and also reducing or eliminating most of my heart meds. I know I will have to put up with increased muscle pain, stiffness, joints hurting, and some newly returned issues with walking. If I concentrate, I can avoid tripping and falling, and I have done so thus far. My walking is OK, not bad, but nowhere near as good as on higher dose. The higher dose I dropped by 50% was also a dropped dose from my best dosage for sypmtoms. But we reduced that a couple years ago due to it making cognitive issues worse. Now, for my question: It looks like I can't increase Sinemet or take any similar meds, so my question is whether there is something else I can do for my newly returned problems. Oh, pain, weakness and limitation of motion are my problems I think. Just wondering if you have any words of wisdom on this point. Thanks very much. Bill. PS: Dr. Okun, I just saw a question I asked you a while back. Although a different initail question, I saw that via follow up questions and responses you actually answered the question I just asked above. I will talk with my neuro about some type of dosing that would produce smaller doses more times a day that total up to the amount we think is my limit due to blood pressure issues. By the way, the dosage I am on right now, forgetting the number of times a day to take it, is leaving me with an almost unacceptable level of pain and the things I mentioned above, but I think that totaly daily dosage is the best I can do, so I now hope to see if using more frequent smaller doses might improve the situation. So thanks for your prior response, which I had totally forgotten about shortly after I got off the computer. I will write this down and give it to my wife so she can make sure we do something about it with advice from my neuro. Thanks again. Bill. OK, another PS: Would the breaking the dosage up into smaller doses taken more frequently work with extended release or just fast release. I currently take extended release because the fast release pills were kicking my cognition in the wrong direction shortly after taking the med, but that doesn't seem to happen with the extended release. Now, I think I have covered all the things I intended to cover in the beginning. Thanks again.
  10. BillBRNC

    What Happens When Sinemet Stops Working

    Oh, my non-motor symptoms are much more of issue than the movement issues, but the Sinemet might be making some of my non-motor issues worse, but after much playing around with doses per my doctor, we are both coming to conclusion that my current dose of Sinemet probably can't be raised without significant conseuence to cognitive and BP issues. I sadly gettting to point where my options are become more limited, but the search continues. The Parkinson symptoms seem to be fluctuating in terms of getting worse then backing off some, then getting worse then backing off some, and so on. This is the same for my non-movment issues from LBD, which have always fluctuated, only now my fluctuation is between moderate to early severe, then back and forth. The base line just keeps getting worse with the progression. Not sure what to do, and I don't think my doctors know what to do either. The cardio and neuro and geriatric guys seem to be at a loss as to what else to do other than the neruo and geriatric guys want to increase doses of the dementia drugs and add another dementia drug. I have been holding back due to the significant bad effects I get from those medications, not to mention they seem to make my Orthostatic Hypo worse with even lower BP. I'm getting tired of all of this. I now look for reaching a reasonable level of decent with all this and then riding it out down the path. Thanks.
  11. BillBRNC

    Help With A Symptom

    I was diagnosed after all the testing and such, along with a Pet Scan, about 2 years ago. But I was diagnosed with dementia a year prior, but the doctor didn't know what type, only that he didn't think it was Alzheimers. At that time, I had not started having Parkinson symptoms. I had the same symptoms at had at time of diagnosis for at least a year maybe 2 prior to getting diagnosed with dementia. So I think I've had sufficient symptoms and findings to diagnose LBD at least 4 years ago, but clearly 3 years ago.
  12. BillBRNC

    Important Sinemet Question

    I got the answer from another reliable source, but thanks for looking.
  13. BillBRNC

    Q About Arm Swing

    The only thing I was able to get is something I got from Dr. Okun. If I recall right, and I guess his response might still be around somewhere on his spot, he said that this was not an unknown occurrence. But it had not been studied much. I think he said one of his colleagues was interested in the subject. I also asked my treating neuro, who said that this was normal to have that sensation. Personally, I would favor whatever Dr. Okun says about a general issue that doesn't require examining me to answer, and I think this is such a question. I frankly just forgot about it and still notice it all the time.
  14. BillBRNC

    Help With A Symptom

    Oh, and my neuro told me that I should feel free to pop a 25/100 fast acting any time I feel the Parkinson stuff get worse, unless it is right close to my next normal dose. You see, my Parkinson problems don't seem to be nearly as painful and disabling as the folks who have true Parkinson's Disease, as opposed to my Parkinson stuff that is an add-on to my LBD. You guys seem to have a so much more physical problems than I do. Good luck. Bill.
  15. BillBRNC

    Help With A Symptom

    S, thanks. Right after I posted this, I remembered that I had some spare fast acting Sinemet. I think 25/100. So took one to see what happened. It seems to have reduce significantly the discomfort in my shoulders and left arm and wrists, but no impact on my right elbow. My short term memory has been gone for a long time now, and I also realized again that I really can't remember how everything felt right before I took the 25/100. But there is no doubt that those parts of my body don't feel as messed up as before, but I can't tell if my right elbow has improved any or not, I just know it still hurts. So maybe what you said is it. Some but not all is Parkinson, but the elbow might just be bursitis. I never had bursitis before that I can recall, and I am 68 years old. Well I ask the neuro the next time I see him. Thanks again. Bill.
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