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BillBRNC

LSTV Big versus Sinimet

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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.

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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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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.

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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.

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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, 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.

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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.

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I've decided to start Big two weeks from Monday, which will be one solid week after I up my Sinemet to 2 pills 3 times a day of 25/100. The result up to now at 1.5 pills 3 times a day have been great. I hope to go up to the 2 pills this coming Friday or a week from tomorrow, which would give me a full week before starting Big. I still have some balance issues, and my eyesight changes all over the place so that makes walking and doing stairs a real challenge, but there really isn't much to be done there. I'm already taking Exelon for the cognitive type stuff, which also includes some eyesight stuff, particularly depth perception and focus Of course, seeing things that aren't really there makes thing interesting, but not much so.

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Bill, I think you will be pleasantly surprised in how much BIG will help.

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