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About TheDucks

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  1. TheDucks

    Sinemet and Vitamin B6 use

    Dear Dr Okun Would you give the contents of multiple vitamins/minerals that you recommend to your PD patients? Thank you in advance
  2. TheDucks

    Requip/Ropinirole and weight gain

    My husband has been on Requip since 2003. For the first 10 years, there was not much change in his weight however since the past 5 years, his appetite has increased without ICD, he gained about 12 lbs, the doctor thinks it also may be entering the 60 years of age.
  3. Dear Dr Okun,

    How often do you recommend your Parkinson patients to see you in the office for regular follow up if there is no new symptom or no significant change in health status? Thank you in advance for your time and advice

  4. TheDucks

    No Sleep For The Weary

    My husband used to have interrupted sleep due to shaking. Since changing his Sinemet regimen without any change to the total daily dose, by taking one tablet of Sinemet at bedtime, he have been able to sleep about 5 hours till waking up for the bathroom trip, then taking another half tablet of Sinemet to sleep about 1-2 hours more.
  5. TheDucks

    A great site for PD information...

    Thank you for sharing
  6. TheDucks

    Blood pressure fluctuations

    Dear Dr Okun My husband also has blood pressure fluctuations. His lowest readings are in the morning, taken about 1/2 to 1 hour after the 1st Sinemet dose of the day. Then the highest blood pressure readings are taken about 10 minutes before the Sinemet bed time dose. Do you think our timing to check blood pressures are optimal to avoid false readings? Thank you in advance
  7. TheDucks

    Widely Fluctuating Blood Pressure

    Dear Dr Okun, Thank you so much for your clearly stated advice. I happen to come across an article regarding the panel discussion about Blood pressure in Parkinson. The panel includes NPF in Miami, Florida. The article can be found at this web linkk https://link.springer.com/article/10.1007%2Fs00415-016-8375-x I do not see your name on the article, are you advising the panel? The panel's recommendations concur with your advice. My husband's BP highest in the range 150 /90 during sleep only between 3am-waking up (6:30-8am) are in the 150 range. He took Sinemet 25/100 at bedtime usually 12:30-1am. Would Rytary taken at bedtime lowers his high blood pressure longer ( assumed less potency) than his current short acting Sinemet 25/100?
  8. TheDucks

    Widely Fluctuating Blood Pressure

    Dear Dr Okun, Thank you for your advice somehow I did not get the notice of your response at all. My husband had 24 hours Blood pressure monitor done at home. The readings confirm that he has high blood pressure (range 150s/high 90s) during sleep and low blood pressure as low as 92/43 during waking. Lowest blood pressure readings are in the morning after getting up then slowly rising and around 5-6 pm, his blood pressure readings are within 110s/ high 70s. His MD specialist explains that this pattern of blood pressure is due to Parkinson diminishing autonomic function. We mention to both his internist and his MD specialist that he will compression stockings (15-20 mmHg) for awake low BP. However we are undecided if to try a short acting medication to lower high BP readings during sleep as his doctors say the medication may lower his waking low BP further. He has sleep apnea (moderate) but unable to use CPAP machine. He took 1 Sinemet 25/100 at bed time around 12am so his BP readings seem to be ok until about 3pm until getting up around 7:30-8am. His cholesterol, weight are good and he walks at least 30 minutes daily since diagnosed with Parkinson in 2013. He has osteoporosis, DEXA done 2016 is lowest at hip = 3.2 . He checks his blood pressure daily before leaving for his walk and if below 90/60, he drinks 1-2 glasses of water. Would you recommend to start a medication to lower his high blood pressure during sleep? Which medication do you prescribe in your practice for elevated blood pressure during sleep ? Thank you for your time and insightful advice
  9. TheDucks

    Widely Fluctuating Blood Pressure

    Dear Dr Okun, Thank you so much for your time and your insightful advice as always. My husband is currently taking Sinemet 25/100 ( not 100/250 previously typo error) as 1.5-1-1.5-1-1.5-1 (last daily dose is 1 Sinemet at bedtime around 12am) He is also taking Ropinirole ER 8mg at 9am. The regimen seems to control his Parkinson shaking. We have Home blood pressure readings from getting up until bedtime around 12 am but unable to get blood pressure readings during his sleep. Would you advise using 24 hours ambulatory blood pressure monitoring to get readings during sleep for Parkinson ? Is the machine still accurate in Parkinson patients?
  10. My husband has had Parkinson since 2003. His blood pressure has been widely fluctuating from 130/90 during sleep to 70/50 during waking up in the morning. He is taking Sinemet 100/250. We are thinking about changing to Rytary and wonder if anyone has experienced less fluctuating blood pressure when switching Sinemet short acting to Rytary? Dear Dr Okun, would you please advise of your experience with Rytary regarding Blood pressure less fluctuating than Sinemet short acting? Thank you in advance
  11. TheDucks


    Dear Dr Okun I read that CoQ10 helps with muscle pain from cholesterol medication statins. My husband has parkinson and has experienced low grade muscle pain. We are looking into CoQ10 for his fatigue partly due to this systemic pain. Would you explain more in your reply " Some people in the study did improve!", which areas are the improvements? Would you give reference study as our neurologist recommends" save the money for a cruise" instead of CoQ10? Thank you for your time and expertise "
  12. TheDucks


    Dear Dr Okun, Does the DAT scan or any test measure the Dopamine level released in the brain? if so, does the level differ if measurement done before started Sinemet treatment? or time interval to Sinemet dose? Thank you
  13. Dear Dr Okun, Do you consider Ultra sound instead of DBS a breakthrough for Parkinson? Do you know any center in USA performs the Ultrasound ? as still not approved by FDA for Parkinson? Lastly, I read somewhere on the internet that severe hearing loss is a contra-indication to Ultrasound? Why? Thank you for your time
  14. Dr Okun Would appreciate your thoughts and your experience about NOW Foods Dopa Mucuna 15% L-Dopa, 90 Vcaps sold on Amazon and made by NOW in Illinois? Thank you
  15. TheDucks

    Mucuna Puriens - A Herbal Alternative

    Has anyone tried NOW Foods Dopa Mucuna 15% L-Dopa, 90 Vcaps sold on Amazon and made by NOW in Illinois? I would also like to ask Dr Okun and K Holder about this NOW Foods Dopa Mucuna 15% L-Dopa, 90 Vcaps