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Daily Journal with Mitochondrial Myopathy

Day by Day with a Movement Disorder

My Journey with a Mitochondrial Disease - "But they that wait upon the LORD shall renew their strength; they shall mount up with wings as eagles; they shall run, and not be weary; and they shall walk, and not faint." Isaiah 40:31 KJV

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Diagnosis in 2006 - Parkinson's Disease and Peripheral Neuropathy, then in 2007 - Essential Myoclonus. Finally in 2011, after a muscle biopsy, I was diagnosed with Mitochondrial Myopathy as well as Peripheral Neuropathy.

Share my journey - coping with the testing, the medicines, nutrition, digestion problems, exercise, the emotions, uncertain diagnoses and no telling what else!

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The New Normal is Settling In

Day by Day with a Movement Disorder Posted on December 1, 2006 by DBDecember 1, 2006 2

We’re getting into something of a routine around here, so things are beginning to settle down. DH has been coming up each morning and helping in any way he can, as I get Daddy up and dressed, and we get breakfast going. Hospice has left the wheelchair, a bedside table, an emergency oxygen tank, and one of those oxygen maker machines that plugs in, for when we eventually need it. The bath lady comes out today, too. And his medicine should be coming via FedEx today, also.

We’re taking turns going home for a few hours during the day, so I can take care of our Internet business and get packages ready to ship. And I can play with our cat for a bit, too. We live right down the street, so it’s not that big a deal.

With all that settling down, my PD symptoms have come under control again, I’m happy to say. My only continuing problem is the lack of sleep, and I’ve given that long enough to get under control naturally. I’m calling the Neurologist today and see what he can prescribe, as I can’t possibly continue at this rate indefinitely.

DH scrubbed and mopped the kitchen floor and brought our good vacuum cleaner up here last night, so we could give the carpets a good cleaning, too. We’ve got the time to do it, so we’ll gradually get the house cleaned up. We’ve had to neglect it this last year, what with our daughter being in the hospital so much and then me being so sick. Daddy has always vetoed any suggestions at paying someone to come in and clean. Because he’s blind, he really doesn’t like strangers in the house, and I can understand that.

I’m not sure yet if we’ll try to find some part time help to give us a day off or two, since Daddy is so uncomfortable with that. It really depends on how much we need it. We have to take care of ourselves, too, and time away from all this is part of that process.

Posted in Uncategorized | Tagged care giving, Hospice, house cleaning, insomnia, Neurologist, Parkinson's | 2 Replies

Care Giving Ain’t What It Used to Be

Day by Day with a Movement Disorder Posted on November 30, 2006 by DBNovember 30, 2006 4

It’s only been less than 4 years since we were care givers for my FIL, keeping him at home with the help of Hospice, after he had been in the hospital. He was in a very nice Assisted Living Home before then, because he resented us, probably for taking him out of his home, and we couldn’t handle his violent outbursts. They never had any problems with him at the Assisted Living. It was an emotionally draining job, but one we have never regretted doing.

Here I am, just 4 years older, and taking care of Daddy has worn me slap out, thanks to PD. My dear hubby has really had to take up the slack and get much more involved in taking care of my Daddy than he would have had to, if I had not developed Parkinson’s Disease. As an example, a couple of days ago my legs stayed wobbly all day long, even after I took my PD meds, and I didn’t trust myself to help Daddy walk, so DH had to do it.

First off, the emotional stress of finding him Friday started me off “in the hole” so to speak, and my medicines never have been able to catch up.

Also, I’ve not been able to get a decent night’s sleep at Daddy’s. The same recliner that I slept in for several years when I stayed with Mama is no longer that comfortable to me, and that’s the only place there is for me to sleep. So, I end up going to sleep early, waking up somewhere around midnight, and spending the rest of the night on the computer. Luckily, I’ve been dozing quite a bit on the computer during the rest of the night hours. But that’s still a poor second to a good night’s sleep.

So we decided the best thing to do was to try to get Home Health or Hospice here to give us some help. That’s why we took Daddy to the doctor’s Monday. Well, Dr. M. followed through, just as I expected him to. The Hospice nurse came today to admit Daddy, and I filled out all kinds of paperwork. They will be sending someone twice a week to help him bathe, a nurse will come by once or twice a week, and they will provide all Depends type products and most of his medicines, too. They’re sending a wheelchair Friday, so we can take back the one we borrowed.

Daddy understands that I need the help, so he’s being very agreeable to all this. She offered to send a hospital bed, but Daddy’s not ready for that yet, so she said just let her know when he needed it. It’s not a whole lot of help, but any is better than none, and with his age and all, he’s bound to need more and more care from now on. This way, all the routines are in place, and he’ll be used to the people coming and going and being in and out of the house. It should certainly make things easier for DH and me, knowing that he’s being seen by a nurse each week.

Posted in Uncategorized | Tagged care giving, Hospice, insomnia, Parkinson's, Quality of Life | 4 Replies

Life’s Unexpected Turns

Day by Day with a Movement Disorder Posted on November 27, 2006 by DBNovember 27, 2006 2

This has certainly been a strange last couple of days for me. It started with my laptop suddenly getting the dreaded Blue Screen of Death over and over, for no apparent reason, right before Thanksgiving. We had all the family coming for dinner, and that meant moving all the eBay stuff out of the guest bedroom, so the grandkids could spend the night. That meant there was no time to work on the ole ‘puter, so I had my first taste of computer withdrawal LOL.

I behaved myself, and only worked on the computer in between housework, as I found out very quickly that I have no stamina at all. I used to be able to move all the stuff quite easily, dust and vacuum, and generally straighten the house with no trouble, but not any more. It seemed like I needed to sit down every few minutes and catch my breath. Thank goodness my dear hubby was doing all he could to straighten up the place, and of course he did all the shopping.

Our family helped out a lot on Thanksgiving, instead of just coming and sitting down to the meal, the way they always have before. Our SIL cooked the turkey, and our daughters took care of the deserts, so DH fixed the vegetables, and I didn’t have to do anything. It’s just as well, as I woke up with those bad stomach cramps and the bloating again on Thanksgiving Day. I spent most of the day with a hot pad on my tummy, ate almost nothing at lunch, but did enjoy having everybody here. Daddy ate almost nothing, and no amount of prodding would get another bite in him. The kids were particularly good this year, as they stayed quiet all day. I asked DD if she had threatened them within an inch of their lives, but she said she hadn’t said a thing to them. So they hadn’t made Daddy nervous, as they sometimes do with their playful noise, so it didn’t make sense that he wasn’t eating.

We had a wonderful time enjoying getting to visit with everybody all at once, particularly since our older daughter and her hubby will be with his parents for Christmas this year. Younger daughter and the girls spent the night and didn’t go home until Friday afternoon, so we did get on our other laptop and do some Wishlist shopping for the girls, so I’ll have some things to pick from that they really want.

After such a pleasant day and a half, even with my stomach cramping, our whole world turned upside down when I got up to Daddy’s to fix his supper Friday evening. I found him in the living room floor, conscious, but unable to get out of the floor. He was not hurt, evidently, and doesn’t remember falling, but he’d been on the floor most of the day. Mind you, he has one of those “I’ve Fallen, and I Can’t Get Up” buttons in his shirt pockets, but he wouldn’t use it! I’ve never been able to get him to use it. No matter how many times I explain it to him, he thinks it’s going to call an ambulance and take him to the hospital. But I have it set to call us, and then a neighbor, and only call the EMT’s as a last resort.

So I called my DH, and he all but ran up there, and got him out of the floor, by the hardest. He was very weak, as he had not eaten since breakfast, and he’s diabetic. We got some juice and a banana into him, and soon realized that he must have had a mild stroke, as his speech was slurred.

So, I’ve been taking care of him now for the last few days. He seems to be getting stronger, and his appetite is improving. His speech is still slurred and I’m being really careful to feed him thick foods like oatmeal, so he won’t choke. I’m not sure what we will do today. It would be extremely difficult to take him to the doctor, and I’m not so sure it would accomplish anything if we did.

As for me, I can really tell the stress has put a strain on my Parkinson’s meds. My balance is poor, because I’m really tired, and my back is bothering me from trying to help him stand up. Luckily, I’ve had lots of practice at care giving, and I do know the correct way to do things, body mechanics wise.

Daddy will be 102 in March, so it’s going to be very difficult for him to recover from whatever happened Friday. He wants to stay home, and I want to be able to help him do that if it’s at all possible. If I could be fairly certain that taking him to the doctor would get us some Hospice help, then it would be worth the trouble of getting him in and out of the car and the doctor’s office.

Posted in Uncategorized | Tagged balance, bloating, care giving, computer addict, family, gas, house cleaning, insomnia, Parkinson's, stress, stroke, swallowing | 2 Replies

Information on Swallowing Problems with PD

Day by Day with a Movement Disorder Posted on November 8, 2006 by DBMay 7, 2016 4

One of my dear blogging friends, Marion, asked me in her comment today for help planning a menu for an Advanced Parkinson’s guest she was expecting, who has trouble swallowing. After Googling on the subject, this seems to be the best general information I could find.

This is an excerpt from a very well written pdf article titled, Parkinson’s and Swallowing.

It is important that you continue eating your regular food until you are no longer able to do so safely. A regular diet with a wide range of tastes and textures is important to keep all of your muscles working, and encourage proper nutrition and hydration. Only if you begin experiencing significant difficulty, you may need to adapt your diet. While each individual will have different problems and therefore different solutions, the following suggestions may help.

SUGGESTED FOOD

• Food that is soft and moist, with a good flavour and smell, tends to be easier to swallow: custards, jelly, pureed fruit, sauces, spices and herbs.

• Avoid foods which are hard, dry, crumbly or stringy.

• Avoid mixed consistencies (e.g. solid plus liquid).

• Be careful with foods which stick to the roof of the mouth or get caught around the mouth: dry mashed potatoes, tomato with skin on, biscuits, bran flakes, hard-boiled eggs.

• Thicker fluids (e.g. nectars, milk shakes) may be easier to control and swallow than thin clear liquids, as they move more slowly.

• Keep food presentation appetising: flavour, smell and appearance of food.

• Relax and enjoy your food. It is good to have a break between mouthfuls and take sips of water during the meal. This will not only help you relax, but also allow you to clear your throat and mouth. You may need to swallow twice to clear each mouthful.

• Eat smaller portions more frequently, especially if time for meals is limited.

POSSIBLE PROBLEM FOODS

• mixed textures, like liquid with bits in (e.g. minestrone soup or watery mince);

• flakey biscuits;

• hard toast or nuts, chocolate, grains, seeds;

• stringy, fibrous vegetables


FOODS THAT MAY BE EASIER TO SWALLOW

• milk

• mousse, custard, yogurt, ice cream

• souffle, omelette

• casseroles

• soup (Creamed would be my suggestion, based on other articles I’ve read.)

• fruit juice, pureed fruit

• pancakes (with syrup etc.)

• soft boiled rice

• well cooked vegetables

• banana.

Hopefully this information will be of some help to Marion as she plans her menu, and possibly to others as well.

Posted in Uncategorized | Tagged diet, eating out, nutrition, Parkinson's, Quality of Life, swallowing | 4 Replies

Michael J. Fox Ad Controversy Makes Me Mad

Day by Day with a Movement Disorder Posted on October 27, 2006 by DBDecember 17, 2021 8

We didn’t watch the World Series, but we did hear about the stink Rush Limbaugh caused when he accused Michael J. Fox of faking his tremors in a political ad he did, endorsing a candidate who is pro embryonic stem cell research.

YouTube – Michael J. Fox political ad

Fox News Story about Limbaugh’s accusation

Michael’s Response to Limbaugh

Limbaugh later apologized, but, IMVHO, that’s just not enough to put out the fire that he started.

Fox developed Parkinson’s at a young age, and he has a particularly aggressive form of it, as well. He’s already had surgery, and you can be sure that he’s under the care of the finest doctors available. Still, his condition continues to worsen.

For any public figure to go on record casting doubt over the reality of the severity of his condition is a disservice to all those who suffer from PD, or from any disability, for that matter. And to think he mocked Michael and imitated the way he was moving … why that’s just intolerable!

We all have our good days and bad days. Just because I’ve been walking just fine, doesn’t mean I won’t need the cane to take the very next step. That’s just the way Parkinson’s works. I’m just newly diagnosed, and this situation made me very angry. I can only begin to imagine how someone whose tremors are disabling must feel, reading about all this. I think I would be outraged.

One writer suggested that Limbaugh should make a huge donation to the Fox Foundation, if he really wants anyone to believe his apology is genuine. At least that way, he’ll do some good and, maybe, somewhat balance the harm he’s done.

Posted in Uncategorized | Tagged fake tremors, Michael J. Fox, Parkinson's, political ad, Rush Limbaugh | 8 Replies

My Prayers Have Been Answered!!

Day by Day with a Movement Disorder Posted on October 5, 2006 by DBOctober 5, 2006 2

I’ve been going to doctors for years with strange symptoms that came and went, that they never could explain. Most of them were attributed to stress, which made sense, but I was never satisfied with the diagnosis. Today, the Neurologist officially gave us the diagnosis of Parkinson’s Disease, and even though that can mean years of debilitating illness, it doesn’t have to be that way. Every PD patient is different. I’m just so relieved to have an explanation for what’s been happening to me, particularly for the last year, that I have been celebrating all day long. Now I have an enemy I can fight!!!

Doctor S has given me the directions today for weaning off of the Sinemet and changing over to Requip, which is a dopamine agonist. There’s no way of knowing if I will be able to use it instead, without trying it, so the next 4 weeks will be another trial. Sinemet is the gold standard of PD meds, but it only works for a limited number of years, before the side effects cause as much trouble as the PD does. So they try to delay starting “younger” patients like me on it, if they can help it. (I don’t call 63 younger LOL)

We also asked about exercise, and he said for me to walk for 30 minutes a day for 4 days a week. From my reading I’ve found that Tai Chi is good for Parkinson’s patients, and I’ve already had some training. I went to the gym on the way home today and talked to the Sensei about giving me some private lessons two days a week for 30 minutes to help me build my balance and stamina again. And Dr. S said I need to do some weight bearing exercise, too, so I’ll be getting back on the mini trampoline, too.

Today is a new beginning for me in a very real sense, and I thank God that I have been diagnosed early, so I have time to improve my health as much as I possibly can. I thank you all for your prayers.

Posted in Uncategorized | Tagged diagnosis, exercise, Neurologist, Parkinson's, prayer, Requip, Sinemet, Tai Chi | 2 Replies

My Arms Were Swinging This Morning!

Day by Day with a Movement Disorder Posted on October 4, 2006 by DBOctober 4, 2006 1

Such a little thing, that we take for granted, and don’t even notice … when you walk normally, your arms swing quite naturally at your sides, without any thought on your part. Well, that’s not the case for someone with Parkinson’s, and it hasn’t been that way for me, either. In fact, I have tried to consciously do it, and I couldn’t remember how to coordinate it at all.

Daddy has a long hall at his house, and I noticed for the first time this morning when I walked down it that my arms were swinging again, quite naturally. This is quite an accomplishment, and is sure evidence that the Sinemet is working.

I go to the Neurologist tomorrow, and I’m very excited about seeing him. I’m hoping for a definite diagnosis this time, so I can get down to the business of dealing with handling the meds and my GERD. I’m still having a lot of trouble with that, but I have the Gastroenterologist appointment Friday. It seems to all be coming together.

I’m praying for some definite answers. I realize that Parkinson’s is not something anyone would want to have, but knowing is better than not knowing, any day, IMVHO!

Posted in Uncategorized | Tagged appointments, diagnosis, gait, Gastroenterologist, GERD, Parkinson's, prayer, Sinemet | 1 Reply

My Legs Were All but Frozen this Morning

Day by Day with a Movement Disorder Posted on September 25, 2006 by DBSeptember 25, 2006  

It was all I could do to walk this morning, so for the first time ever, I used the cane when I went to fix breakfast for Daddy. Before I was on the medicine, I was able to hold onto furniture and walk enough, so I could hide how bad off I was from Daddy, since his vision is so bad. But I didn’t have a choice this morning. He was upset, but I couldn’t help it. I’ve been gradually telling him what’s going on, so I could keep it from being such a shock, anyway.

Our pharmacy does have voice mail on when they’re not open, so the doctor’s call went through yesterday evening. Trouble is, our pharmacist doesn’t have the medicine and can’t get it until tomorrow. So we checked with a nearby town’s CVS, but they didn’t have a full amount of the prescription. My DH got the prescription, but it took several hours for it to be ready.

We finally got the medicine about 1:00PM, so I took the Sinemet and the Lodosyn together, and I had a baked potato for lunch at 1:30. I dozed a bit, but so far the legs are still very wobbly.

Lodosyn is an additional dose of Carbidopa, added to the Carbidopa that is already in the Sinemet. It does not help with the Parkinson’s symptoms, but it helps control the bad side effects of the Lodopa in the Sinemet, which is what changes into Dopamine in the brain. That helps to replace what the brain is no longer producing.

Posted in Uncategorized | Tagged cane, difficulty walking, Lodosyn, Parkinson's, Sinemet | Leave a reply

Nutrition Suggestions for GERD plus Sinemet

Day by Day with a Movement Disorder Posted on September 25, 2006 by DBApril 17, 2021 2

After spending this weekend nauseated, it is obvious that I’m going to have to be very careful not only with when I take my medicine, but also with what I eat. After doing a lot of research on my own, and getting a general idea of what I need to have, I was at a loss as to how I was going to decide on a diet, taking my GERD into account.

So I wrote to Jackie, a fellow BLOG VILLAGER at The Vegan Diet, who was kind enough to put together some information for me. She’s done such a wonderful job of pulling together just what I needed that I thought it might help someone else, so here are her suggestions.

I see with GERD you must steer away from :

* fatty or fried foods * peppermint and spearmint * whole milk
* oils *onions * chocolate *high sugar content * creamed foods or soups
* most fast foods * citrus fruits and juices (grapefruit, orange, pineapple, tomato)
* coffee (regular and decaffeinated) * caffeinated soft drinks * tea
* other caffeinated beverages *Spicy or acidic foods

You can have :

apples, berries, melons, bananas, peaches, pears
chicken (no skin), fish, turkey (no skin)
fat-free milk and yogurt
milk free breads
a miniscule amount of fat or butter

Basically my advice is lots of small meals a day, not three meals a day. I eat 5 meals a day, like many people do now for many medical conditions and to keep weight average (not under or overweight), as it keeps my IBS and my sugar levels on track. A few ideas below, not totally vegan, plus useful links at the bottom.

Breakfast

Fruit is good. Papaya is the best I find when I am acidic. Herbal tea (not mint)

Mid morning

Fruit Apples, melon, bananas and nuts like almonds and walnuts (most nutritious).
or Bean dip (chick peas or beans blended with a tiny amount of oil just to make it cream cheese consistency and a fresh herb like cilantro) on a slice of white or brown bread (not seed bread or wholewheat)

Lunch

Tofu dip (no oil with it) with raw vegetables like carrot sticks or
Veggie Soup with tofu cubes

or this Fish Dish recommended by a GERD sufferer:

This recipe is for one serving. Increase the ingredients for additional servings as needed.

One 4oz filet of white fish (orange roughly, sole, turbot, flounder, etc)
One med. Potato. Steamed green vegetable such as broccoli, spinach, peas or asparagus
Parsley or chives for garnish. ¼ tbsp unsalted butter, olive oil or Pam

We will start with the potatoes, because they take the longest to cook, and they tend to retain their heat the longest. The fish and vegetable take only minutes to cook.
Peel and cube potato. Place in cold water to cover. Bring to the boil, and then simmer until fork tender. Drain, leaving just enough cooking liquid for mashing or whipping. You may also use the vegetable broth (recipe below) instead. Add salt to taste. Hold in a warm place. Season fish with salt and pepper to taste. Place non-stick sauté pan over med high heat. Add butter, oil or spray with Pam. When not quite smoking, add fish. Cook two minutes, turn and cook other side for two minutes, or until the filet is light brown and cooked through. If the filet is very thin, one minute on each side may be enough. (You can broil or bake the fish if desired). Serve fish on top of mashed potatoes, surrounded by the steamed vegetables. Garnish with chopped parsley or chives.

or Savory Lentils with Texmati Brown Rice

1/2 lb of organic green lentils (2 ½ cups), rinsed 4 cups water or stock
1/2 onion, chopped 1 cloves of garlic, chopped 2 carrots, sliced
2 stalks celery, chopped 1 bay leaf 2 sprigs of thyme, or ½ tsp dried
Organic Texmati brown rice (follow instructions on package)

To a large pot bring water and lentils to a boil. Add other ingredients. Reduce to the simmer, partially covered. Cook until tender (about 20 to 30 minutes), stirring occasionally and adding more liquid as needed.. Remove the bay leaf and thyme sprigs. Season with salt and freshly ground black pepper to taste. Serve over organic Texmati brown rice. Garnish with chopped parsley. Serve with a light green salad, dressed with the lemon chive dressing above.

Mid Afternoon

Herbal tea (not mint) or glass of strawberry soy milk or flavored fat-free yogurt

Early evening (best for supper)

Grilled or dry stirfried turkey or chicken without skin and steamed or stir fried veggies and mashed potatoes/baked potato or pasta

or Broiled Burgers with Mushrooms and Rice

1 lb lean (10% or less fat) ground beef
1/4 cup seasoned bread crumbs
1/2 tsp dried rosemary (crushed)
2 tsp dried parsley, divided
1 egg white
Nonstick vegetable cooking spray
1 tbsp olive oil
2 cups mushrooms
1 cup fat free skim milk
1 tbsp flour
1 1/2 tbsp Worcestershire sauce
1/4 tsp salt
1 cup long-grain brown rice, cooked according to directions

In a bowl combine ground beef, bread crumbs, rosemary, 1 tsp parsley, and egg white.
Mix well and make into four 3/4″ thick patties. Spray a broiler pan rack with nonstick vegetable cooking spray. Place patties on rack and broil 3 to 4 inches from heat for 5 to 6 minutes on each side or until desired doneness. Put olive oil and mushrooms in a skillet sprayed with nonstick vegetable cooking spray over medium-high heat. Cook 3 to 4 minutes until mushrooms are soft. Combine milk and flour together in a bowl. Add mixture to skillet. Add Worcestershire sauce, the remaining 1 tsp parsley, and salt. Stirring constantly with wire whisk, cook sauce 3 to 4 minutes until thickened. Serve mushroom sauce over broiled burgers with hot cooked brown rice. Makes 4 servings.

3 hours before bed

Another snack like a banana or a cup of clear soup

***************************
Gerd friendly recipes – Vegan and meat eaters (index in right column)

Fat Free Vegan and Vegetarian Recipes

Non Vegetarian Dairy-Free (lots of ideas and substitutes)

VegWeb Fat-Free Recipes plus tons of other recipes that should be suitable

Free Vegan Cookbooks (fabulous ideas) to download

Physicians Committee for Responsible Medicine:
Parkinson articles

I had asked Jackie to help me find foods that would be suitable for a GERD diet and take into account the fact that Sinemet cannot be taken with large amounts of protein. I’d say she went out of her way to be helpful, wouldn’t you? But I shouldn’t be surprised. Every post she has on her blogs is just this thorough.

I can’t thank her enough for all this information, but I can ask you to visit her blog, so please stop by


The Vegan Diet

Posted in Uncategorized | Tagged diet, GERD, nausea, nutrition, Parkinson's, Sinemet | 2 Replies

Developing Our Plan of Attack

Day by Day with a Movement Disorder Posted on September 23, 2006 by DBSeptember 23, 2006  

In order to understand my approach to having a chronic illness, you need to know a little about me and my side of the family. My grandmother had and my Daddy has Macular Degeneration. My Daddy has been legally blind now for over 30 years, gradually losing more and more of his sight, but never doing anything to prepare himself for being blind.

I’ve said for years that if I were ever diagnosed with the beginnings of MD, I’d immediately start learning Braille and take classes on how to take care of myself from a low vision standpoint.

My approach to any illness is to search the Internet for every bit of information I can find. I have a Chemistry major, with a strong background in Biology and Biochemistry, so the technical papers usually make at least some sense to me.

With that said, it shouldn’t be so surprising that I’ve spent almost all this week researching everything I can find about Parkinson’s Disease. I’ve found bits and pieces of information on various sites that I’ve bookmarked for myself, but the links that have the most information, presented clearly, I’ll be listing in the right hand column.

DH and I are working together, bouncing ideas around as we try to understand how to balance the medicine with the foods that interfere with the medicine, but are necessary for good health. I did my first set of the PD exercises today, and DH bought a different cereal for me, based on the nutrition information I found.

By the time I see the Neurologist again, I should have a good idea what I need to ask him about. Of course I’m still assuming the DX is going to be PD, but at least I feel like I’m doing something besides waiting for the next appointment.

Posted in Uncategorized | Tagged diagnosis, diet, Neurologist, nutrition, Parkies, Parkinson's, PWP, Quality of Life, Search Engines, Sinemet | Leave a reply

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