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Dr. Okun

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Dr. Okun last won the day on September 6 2017

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About Dr. Okun

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    Advanced Member

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  • Location
    University of Florida
  • Interests
    Parkinson disease and movement disorders
  1. Untreatable Dyskinesia

    We ask new patients to hold meds starting the night before (so around 9-11 at night take your last dose). We can make a plan that includes local followup. If you want to see rehab specialists while at UF make sure you call and request PT, OT, Speech. This is our standard first visit and we will give you recommendations for local followup if you can't travel. It is common for people not to be able to travel. Most new patients request PT, OT, Speech and Swallowing as a minimum so they can take recommendations locally.
  2. I will post this comment for you! Happy holidays!
  3. Untreatable Dyskinesia

    I am not sure if this is directed at me but I work at the University of Florida in a city called Gainesville.
  4. Follow Up Sinemet Question

    Hang in there Bill and good luck.
  5. Barium swallowing study

    Thanks for the question. The dye is usually barium and it is usually safe. We use it all the time in Parkinson. Hope that helps.
  6. Energy

    Many people use exercise and also will examine potential medications that can be causing diminished energy. Sleep studies are also very useful as in many patients it is a hidden sleep disorder affecting energy....these are a few things to consider.
  7. Dystonia

    Yes, high doses of medicine, high pump settings and even some DBS settings can precipitate "on" dystonia.
  8. Follow Up Sinemet Question

    Its really hard to know but I doubt it. You and your doc can experiment with doses and figure it out. Based on the description many patients do well with an antidepressant and more frequent lower doses of sinemet (some component of anxiety). Sometimes I add clozapine which requires blood monitoring.
  9. B1 thiamine injections many studies done

    Merry Christmas.
  10. Follow Up Sinemet Question

    Can you help us by specifying exactly what symptoms you are attributing to the Lewy Body? What are the behavioral symptoms? Paranoia? Confusion? Other? Thanks.
  11. Incorrect. Amantadine can suppress dyskinesia in many cases. Entacapone (Stride-PD study) can worsen dyskinesia. I usually stop entacapone first and then adjust regular sinemet or madopar. If dyskinesia persists I may add amantadine.
  12. Me Again. Q about Sinemet Adjustment

    Our pleasure. Happy holidays.
  13. Untreatable Dyskinesia

    Yes, of course someone in our practice can help if you come down. Happy holidays.
  14. Constipation

    No, only manual disimpaction. If you need surgery then you are obstructed. Surgery is not the long term answer. We have a constipation formula on the UF Movement Disorders Site. Also you should ask your doc about new drugs for this issue.