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The Duopa pump has a dopamine intestinal gel which is a gel form of dopamine replacement....

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This is just published in the Lancet Neurology and this month's What's Hot Column addresses this topic.  It is an option if available for people with off time and on-off fluctuations.  Apomorphine SQ under the skin pump. http://www.parkinson.org/blog/whats-hot/Choosing-Between-Subcutaneous-Apomorphine-Infusions-Intestinal-Pumps-Duopa-and-Deep-Brain-Stimulation-TOLEDO-Trial

 

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I have been trying the apokin shots which have been really helpful especially in the late afterrnoon  when things start to fall apart.

unfortunately i have been having sob while taking it. I had some SOB before taking it which i think is related to being so tired.  I dont sleep well at all which leads me to alot of yawning.

Is it safe to assume that if I get SOB with the injections that using the pump  I would have the same issue. I had a check up and my heart and lungs were fine.

Would it be dangerous to continue taking the apokin just in the early afternoon?

I am always SOB when I am off (which seems to be alot lately)

i came across an articlle in clin drug investigation  by w khan et al 2009(there actually were  several articles)

There was a pt who was having SOB while off which is what happens to me

they found that by adding entacapone to his regime that it helped. Does that make sense and would you recommend trying it.

I am on a regime of rytary, IR Sinemet, amantadine, azilect

I usually take 3 rytary @ 630,9,12 and 2 rytary @3 (if I take it any more @ 3 then it keeps me up @ night

I then take 3 IR Sin at 630,9,12 and @ 3 I take 4 IR sinemet

Then @ 430,630-7

I drink 8 tbsp of liquid sinemet which is made from 1 cup water and 13 iR sinemet 2 vitamin c

I grind that all up and mix with 1 cup of water.  I started doing this b/c the food i was eating was interfering  with the absorption of my medicines.

I hope I explained everything clearly

some times i just cant get it right

Would appreciate your input  

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It's tricky and often trial and error to improve the symptoms you describe.  It may be that the wearing off is the underlying cause of the shortness of breath.  We usually switch in our clinic to every 2 hours of immediate release sinemet and if we can't find a good dose we consider Duopa pump, DBS, or sometimes cannabinoids.

Apo shots can help with off's; but the shortness of breath may be the off and not the apo.  There is a new apo pump in trial (recent article).  Maybe the pump would help?

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whoops 

I  was hoping that the new pump would help but it uses the same medication  that is in the shots I have been taking 

that i have been having SOB so I probably would have SOB from the pump dont   you think?

Would it be possible to only use the apokin for special occasions where I really dont want to be off?;

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do you think adding entacapone would help with the SOB

there are quite a few studies that suggest it might

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Moving doses of dopamine closer together may help; some people add comtan or drugs like it but watch out for dyskinesia as sometimes you need to reduce the Sinemet dose; you can take apo shots and sometimes a pump (Duopa or Apo) will help smooth out on's and decrease off's.  You can have a pump with DBS.

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i have tried the apo shots and they make me sob so i cant take it. Is the new sq pump they are studying using the same medicine that is in the shots if so i wont be able to use that pump

my medication doses are 2-2.5 hrs apart already

Does the dupoa pump use the sane medicine which is used in the sq pump

How has the duopa pump been working out  

thank you for taking the time to answer my ?? 

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Apo pump uses apomorphine similar to the shots.  Duopa pump uses carbidopa/levodopa intestinal gel.  Many people are reporting the pump helps with off times.

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