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christie last won the day on March 27 2017

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  1. christie

    Trying Sinemet

    Patriot, I'm glad you started Sinemet! It's been months since you started taking it, but I just saw your post and wanted to comment. The side effects you mentioned (nausea and vivid dreams) are only temporary. Your brain needs time to adjust. You may have titrated up the dose faster than you should have. You just need to take it slow, until you find the right dosage/frequency of dosing. It may take months until you get there but once you do everything gets easier. Levodopa is the simplest and best drug for PD symptoms. It comes with its own limitations of course, but, still, it has an unsurpassed effectiveness on our symptoms and manageable side effects (aside from dyskinesia...).
  2. christie

    Dystonia and early onset

    Dr Okun, could you please further elaborate on this and provide the link to the above paper? Thank you!
  3. christie

    Aspiriation Fluid

    I agree with Dianne! The first step should be an evaluation by an ENT specialist. He may perform -if needed- a flexible laryngoscopy- to watch you swallow solids and liquids and evaluate your condition (flexible laryngoscopy is a very simple and well tolerated procedure, nothing to worry about). The next step is a speech and swallowing therapist (not necessarily a MD) with expertise in functional/neurological dysphagia !! Based on the evaluation of the ENT, and under the guidance of your neurologist, the therapist will inform you on all your options, give you valuable tips that will help you swallow safely and start you on specific exercises for muscles involved in swallowing. Expiratory muscle strength training is an example of physiotherapy which has shown excellent results in improving swallowing difficulties. Other much simpler exercises, such as chewing gum, may also help!!! My dad -who also has Parkinson's- has significant swallowing difficulties. We have just finished the first step -the ENT evaluation- and are now looking for a therapist so that he starts therapy as soon as possible. Swallowing is a very important function and you should follow "aggressive" treatment to preserve it. Good luck and keep us posted!
  4. In that case, atypical degenerative parkinsonism (Parkinson's plus syndrome, such as MSA, PSP or CBD) is a possibility, provided there are also other symptoms/red flags suggestive of these syndromes AND rapid disease progression. Notably, the primary criterion of PD exclusion, i.e. non-response to levodopa, must be confirmed by an experienced MDS. In many cases levodopa doesn't seem to work due to other causes (absorption issues, dose adjustment issues etc. ). When these problems are corrected, the patient responds...
  5. Patients who eventually get diagnosed with MSA typically have abnormal Datscans early in the disease course. Similarly to PD. Datscans CANNOT differentiate between PD and MSA cause they are abnormal in both occasions. A normal Datscan -or, even more so, a series of normal Datscans within several years from diagnosis- strongly argue not only against PD but also against MSA. Thus, the diagnosis MSA is not typically considered for patients with parkinsonism and normal Datscan (s). The differential diagnosis of patients with parkinsonism and normal Datscan may include dystonia, essential tremor and several types of secondary parkinsonism: vascular parkinsonism, hydrocephalus, drug-induced parkinsonism (such as antipsychotics), or toxin-induced parkinsonism (such as manganese poisoning -may be observed during occupational exposure, as in welders, after chronic use of ephedrine-based psychostimulants or even after chronic use of bath salts made from ephedrine!!).
  6. christie

    Diagnosed today

    I find the new forum quite confusing too! It's much more difficult to find new content/follow topics now. Not parkie-friendly...and, for some reason, I also find it kind of "uninviting", especially for new members. could be just me of course. Stephen is a very dear friend of mine, a sensitive, intelligent, amazing man, an excellent diagnostician/pathologist and a very talented artist (painter and writer). It would be a real gift to patients if he started practicing medicine again.
  7. christie

    Stage 3 & 4. Candid discussion. ??

    @NN: None of us is a neurologist and we cannot possibly suggest any diagnosis. We are just patients, and nothing more. Our knowledge is based on personal experience alone. That said, from what I've read and what I've experienced myself as a patient, I don't understand why a diagnosis of MSA is even likely to a patient like you. 1)Datscans are typically positive in patients with PD-plus syndromes. You have had a series of normal Datscans arguing against the presence of degenerative parkinsonism 2)MSA is typically and in the overwhelming percentage of cases a rapidly progressive disease; most patients are bed or wheelchair-bound within the first 5 years. ALL functions are severely affected, including the ability to talk, write, communicate. Thankfully, you don't seem to share none of these aggressive features. 3)MSA responds poorly to levodopa. Levodopa response in MSA patients is typically medium at best and transient. Any patient responding well to this drug after 4+ years of treatment is highly unlikely to have MSA. 4)MSA is characterized by severe symptomatic autonomic impairment. That's the reason MSA patients can't stand up, walk, perform normal activities. Subclinical evidence of autonomic dysfunction, documented by diagnostic testing, does not suffice for a diagnosis of MSA, and is non-specific -found in many neurological and other diseases. I have used the term "typically", because it must of course be emphasized that there are exceptions to the above clinical presentations, with slower progression, better response to levodopa and "milder" symptomatology, but, again, I highly doubt you fulfill the diagnostic criteria. NN, I really hope you don't have MSA, I don't believe you have it, and urge you to ask for another opinion from a MDS. I remember that both you and your husband have a positive history of Lyme. Has neuroborelliosis been ruled out? (now, THAT's a diagnosis almost impossible to pinpoint..).
  8. christie

    Stage 3 & 4. Candid discussion. ??

    NN, I think you need to get a second opinion. Datscan is highly unlikely to turn abnormal after a series of 4-5 normal results. Anyhow, Datscan cannot differentiate between PD and MSA (It is positive in both diseases). I'm sure you neurologist is great and highly experienced, but even the best doctors make mistakes. Some doctors don't easily change their opinion/diagnosis, despite all evidence to the contrary.
  9. christie

    Stage 3 & 4. Candid discussion. ??

    You are much more than welcome sweetie. You are one of the few people -thankfully without PD- who can understand how we feel. I'm sure you will be of tremendous help to many parkies (and non-parkies) cause you are empathetic, kind and knowledgeable. Please stay among us and be our friend. Share with us your fears and thoughts. You don't need PD to be one of us. You already are one of us. Christie
  10. christie

    Stage 3 & 4. Candid discussion. ??

    Datscan is typically (in the overwhelming majority of cases) positive not only in PD but also in PD-plus syndromes. So, a series of negative Datscans may strongly argue against the presence of degenerative parkinsonism in general (be it typical-i.e. idiopathic PD- or atypical- i.e. MSA and other PD-plus syndromes). Nothing is 100% accurate of course. I just wanted to point out that, theoretically, chances of a MSA diagnosis in a patient with negative Datscans is very very small. Good luck NN!! Keep us posted on the final diagnosis!
  11. christie

    PD diagnosis by blood test?

    Gardener got it right!! Since NFl levels are within the normal range in patients with Parkinson's, this blood test is NOT useful for the diagnosis of Parkinson's disease per se (i.e. differentiation of PD patients from normal subjects) . However, it may be of use in the differential diagnosis of PD from atypical parkinsonism (PD-plus syndromes: MSA, PSP, CBD).
  12. It's always nice to know that your fellow patients care for you and want to help you (aside from arguments, disagreements or theoretical discussions). If a fellow patient showed that kind of interest for me, I would more than appreciate it, and of course make sure I showed this appreciation to him/her, even if I disagreed with his/her views.
  13. I'm happy for you Patriot. Remember, I only want the best for you. I just think you are needlessly depriving yourself of a very effective and relatively safe drug. I support 100% your decision to refuse taking a drug (Mirapex) which has made you feel worse rather than better in the past, but levodopa is no dopamine agonist. It is much more powerful, and its strong effect is not accompanied by the nasty side effects of DAs. That said, if you insist on following the no-drug route, I will be rooting for you.
  14. Ups! Sorry, I didn't notice the date of the post. I only want to help Patriot, that's why I'm encouraging him to start levodopa. I'm convinced it will help him much more than he can imagine. Plus it will only augment any other positive effect, of exercise or cannabis.
  15. Sorry to go off topic for a while, but this is important... Patriot, I admire your perseverance and power of will to maintain a demanding exercise regimen, with obvious, multi-level and undeniable benefits not only for your PD but your health in general. However, I also think you are over-dramatizing the potential negative effects of levodopa- a drug you have never even tried!- while under-stating and grossly overlooking the effects of the disease. Falls, even if decreased in frequency, are an alarming sign that you should have started levodopa treatment. I don't think there's any other way to look at this. Levodopa will only help you feel better, exercise more and derive increasing benefits from your exercise. I've been on levodopa and Azilect for the last 4 years, starting 3 years after my initial diagnosis, and feel 10 times better than before starting meds.