Tag Archives: Requip

Testing … Testing … This Is Only a Test

Day by Day with a Movement Disorder Posted on by 15

I thought I’d o a post without any back spacing or spellchcking, just to give you folks an idea of what my typing is like these days. This will also give me a benchmark as to the extent of my mind/finder coordiatniton at this time. so bear with me while you try to read my gobbledytook. LOL

Daddy an di both ahd a good night’s sleep slast night!! so I’m much more rested to day that usual. We;re beginning to settle into something of a routine finally, alsthough we’re still experimenting with ways to make the lift help us the most effiiently.

I did have to call the night service night efore last, because he was choking on his own spit in the bed about several hours after he went ot sleep. I tried moving the head of the bed up and down and turning him from side to dide, but nothing seemed to help. I think the nurse thought i was describing a death rattle when I first talke to her, but I assured her that I knew that sounded like. She said to wake hime up and see if that would help with stronger coughting. I let the bed flat, turned him onto this side, slapped him on the back the way cystic phibrosis patients done, and this huge glob of thick mucus finally came up. Surprisingly, he went right bakc to sleep, and slept well the rest of the night. I didn’t thogh, as I was afraid it would happen again.

I seem to be going from one problem to another, as far as I’m concerned. Now it’s my back hurting again. It’s not the vertebrae, but the muschles of my upper back. That’s from leaning across Daddy, even though we have the hospital bed. This is definitely from the Parkinson’s, so I guess it’s time to add the Requip to my meds again.

I can tell immediately when I make the se spelling mistakes and typing mistakes. At least I know it’s wrong, but I take spellls of not being able to cooridante everything einvolved in acutally typing, And I really wa sa good typist, so it’s not because I don’t know how LOL!!

Well, of you’ve srubbled thorugh this you have some idea of the whats’ involved in turning out a post the way they usually lool. It’s the same with comments.

Did I say that Parkisons’ is a terible disease? And I’m ant Stage One!!!!

Strange Things Are Hapnin’

Day by Day with a Movement Disorder Posted on by 2

I went to my Neurologist last Friday, and I explained to him all that had been going on the whole time I was trying out the Zelepar. He agreed that the medicine had not received a fair chance at working. So, he gave me a prescription for it, with instructions to use if for a month. If I was not pleased with the way it relieved my symptoms, I could then add the Requip I have taken before back to my schedule. Now that my digestive system is behaving, I told him I thought I could handle the Requip just fine.

Of course, being the little town that ours is, our Pharmacy didn’t have the Zelepar in stock. He has to order unusual medicines, but they come the next business day, and that works OK, most of the time. Of course this was Friday afternoon, when we dropped off the prescription, so I was without all weekend. I did the only thing I knew to do – I used the Requip I already had. My tummy didn’t complain a bit, either.

My throat is still irritated, and I finished the antibiotic today, so I’m thinking I’ll see if the nurse will swab my throat again, or just refill the prescription. I’m not convinced that the strep is gone, and I can’t afford a relapse. I had rheumatic fever as a baby, so my heart is particularly vulnerable to strep infections.

I’m feeling good about the medicines Dr. S. has me on for the Parkinson’s now, and I’m sure my GP will take care of my throat, so things are settling down for me.

It’s just as well, because Daddy continues to decline. His arm is much better, thanks to the arm band, but his mind, and his body in general, continue to go down hill. We’ve had some difficulty all along getting his bowels to move, as one might expect from a 101 year old. I was using the glycerin suppositories I had to help him go, plus he is on Colace as a stool softener. The last time I used the suppository, it didn’t help, which I thought was strange. So, I figured, since I use two of them, I’d use two on him. To my surprise, I discovered the first suppository still in place – not melted in the least! His body temp is so low that it didn’t dissolve!!

So, even though I had been trying to put it off, I felt I had to call the Hospice Nurse, and request help giving him an enema. The enema was an ordeal for him, but it helped. That was yesterday. Today, his strength is noticeably less, and his confusion is noticeably more. His mind and body just can’t cope with any kind of assault now, even if it’s for his own good. Going to the Orthopedist sent him downhill, and the enema just pushed him that much further.

I can only pray that I will do well on the Zelepar, or the Zelepar and Requip combination, as I think it’s clear that Daddy has taken a definite turn for the worse. In God’s good time, this will all work out. I just have to take one step at a time, and leave the end results to Him.

A Clinical Trial of One??

Day by Day with a Movement Disorder Posted on by 2

In a real Clinical Trial, doctors use a very large number of people, usually, but not always, divided into two groups. One group gets the medicine being tested, and the other group gets fake medicine, called a placebo. At the end of the trial, if the people getting the real medicine have improved considerably more than the group getting the placebo, the medicine is assumed to be the cause of the improvement. That’s a good thing!

They use such large numbers of people to conduct these trials, because there are always going to be unforeseen situations that influence the effectiveness of the medicine for some people. Maybe a few of the subjects have an undiagnosed disease that makes even the best of medicines not work. Or maybe some of them are under a lot of stress that ruins their results.

When you see a new medicine being talked about with glowing praise of its effectiveness, you have to be very cautious about getting all excited about it. I have seen reports like that where the trial only had 16 people in it. That only gives doctors a hint that a certain medicine might be helpful. It’s just not enough people to tell you much.

That’s the problem with trying to find the right medicine for me, or any other PWP. We are, in a very real sense, our own Clinical Trial. The last time I was on Requip, I was terribly bloated, with horrible stomach cramps and gas. So, the Neurologist took me off of it, and he put me on Zelepar. That medicine dissolved under the tongue, so it doesn’t bother the digestive system. My stomach improved tremendously. The question is, was that because of the Zelepar, or was it because, that same week, my Gastroenterologist changed the prescriptions I was taking for my stomach? Also, my symptoms were not alleviated as well when I was on the Zelepar — BUT I had strep throat most of the time I was trying it, without knowing I was that sick.

There’s no way to be sure, is there, with more than one medicine being changed at the same time, and with me being sick, too? I talked with my Neurologist yesterday about this, and the fact that I had gone back to 1 Requip pill a day for several days, because I ran out of the Zelepar samples before my appointment. Even though I had been on the Requip for several days, my stomach was doing just fine.

So, Dr. S. has prescribed another month of Zelepar, to give it a fair trial at helping my PD symptoms. If I am still not getting as good a results with it as I was the Requip, I am to add the old dosage of 3 times a day of Requip to the Zelepar, which I take 2 times a day. I don’t see Dr. S. for 6 more weeks, to try to give me a chance to tell what is going to work best for me.

Parkinson’s Disease is different from many diseases, where there is some MRI or blood test that will tell the doctor what is helping, and what is not. With PD, it really is up to me. I have to be the judge for myself if the Neurologist has prescribed the right medicine and the right dosage. Then he bases my prescriptions on his vast experience with many other PWP he has treated.

But it still boils down to a Clinical Trial of one – ME!

Tummy Improvement OR Walking Faster?

Day by Day with a Movement Disorder Posted on by 8

I’ve been on the new Zelepar medicine for several days now, and my digestive system is behaving just fine. I don’t seem to be getting quite as much help with my gait as I did with the Requip or Sinemet, however, but I’m still on the samples. When I go back to the Neurologist next Friday, it may be that he will order a prescription for a higher dose or more doses, which might make the difference. Anyway, even if the dose stays where it is now, it seems like a reasonable trade off between stomach problems and balance and walking problems. I’d love to walk better, but I can live with it the way it is now, if I have to. It’s nice not to spend part of every day miserable, with a hot pad on my tummy!

I said at first the Zelepar didn’t taste bitter, however, I’d better amend that evaluation. Yes, it is bitter, but not enough to bother me, anyway. (The trick is to be sure you place it under, not on, the tongue.) It dissolves under my tongue so quickly that it’s just a few seconds, and I can swallow it. You’re not allowed to drink or eat anything for at least 5 minutes before or after taking it, but my saliva quickly washes the taste away.

We’re still staying with my Daddy, which means I spend most of my days and every night in a hot house. We tried to find a compromise temperature for the thermostat, but at 101, he gets too cold, while we’re still sweltering. I have noticed that I’m having more trouble with the heat this week, since I’ve been on the Zelepar, than I was before I started taking it. I’m getting what feels exactly like hot flashes several times a day, and I’ve been past that stage for some time now. I have read that Parkinson’s can mess with the body’s regulation of internal temperature, so I guess that’s what’s happening to me right now. Or is it because of the Zelepar? I really don’t know.

I was on Requip before starting the Zelepar. Requip is a dopamine agonist, but Zelepar is an MAO-inhibitor, so they don’t attack the PD symptoms the same way. There’s big news in the Birmingham News today that a doctor at UAB is close to getting FDA approval for a patch version of a dopamine agonist. That will be good news for me, as the Requip did a better job of improving my balance and walking than it looks like the MAO-inhibitors are going to. I’m all for any PD med that I don’t have to swallow!! So this is something else for me to be hopeful about.

It’s great to see that there is good news on the horizon for the large number of people who really suffer with this disease. My own symptoms and discomfort level are so mild compared to people who have had Parkinson’s for years. I pray that all this new research may bring them relief in the near future, instead of years from now.

First Dose of Zelepar, My New Parkinson’s Medicine!

Day by Day with a Movement Disorder Posted on by 2

This is the day I have been waiting for for about two weeks now. I spent that time tapering off of the Requip I had been on, went without any PD medicine yesterday, and this morning I took the first dose of Zelepar.

Zelepar is a quick dissolving tablet form of Selegiline, which dissolves under the tongue. It tasted a little like an orange mint might to me, but it does dissolve extremely fast. There was also a little tingle on the tongue, but nothing uncomfortable. I had read somewhere on the Internet that it tasted bitter, but, for me at least, that was not so. The directions emphasized not to drink any liquids or eat anything at least 5 minutes before or after taking it. I’ll be taking it twice a day while I’m on the samples, but I’m to go back to the Neurologist at the end of this two week trial.

I felt my walking begin to smooth out within about 30 minutes. It may be my imagination, but I think it’s made me a little hyper, too. (Of course, I’ve been so slow the last two weeks it may be I’m just normal now.) I’ll have to be careful when I take the evening dose, if that’s so, or I won’t get any sleep tonight. LOL

I’ve been reading the explanations of what a MAO-inhibitor is, which is the class of drugs that Selegiline falls in, and I think I’ve got it figured out. Basically, it’s some kind of high powered targeted anti-oxidant, that keeps the smaller amount of dopamine that my brain is making from being broken down prematurely. So I’m getting the full benefit of what my brain is naturally producing.

There is also some research that suggests that Selegiline may actually protect the part of the brain that makes dopamine, and possibly slow down the progression of this disease! If you’re not really familiar with Parkinson’s Disease, that may not sound so significant, but it would be quite a break through. All the other meds treat symptoms only. There is a possibility that Selegiline may effect the cause of Parkinson’s!! I’ll not go so far as to get my hopes up for that, but you bet I’ll be watching to see if that turns out to be true.

Tapering Off Requip

Day by Day with a Movement Disorder Posted on by 6

When I went to my Neurologist last Tuesday, we decided I would stop taking the Requip, since it was probably the cause of all my stomach problems, other than the PD itself. Also, it was the likely culprit for my hair loss. So, Dr. S. told me to taper off the Requip before I changed over to the samples of Zelepar he gave me. That meant last week I only had two pills a day, instead of the usual three. Starting Tuesday of this week, I’ve only been taking one a day.

Dopamine is the brain chemical that controls muscle movement, and that’s the one that people with Parkinson’s no longer make enough of. Requip tricks the brain into accepting the chemical in it as a substitute for the dopamine, so it’s called a dopamine agonist. Now that I’m down to one pill a day, I can really tell it! My balance is terrible, and my walking is stilted and jerky.

As long as DH can take over the care giving tasks I’m not up to, I’ll continue to do as much as I can to help Daddy. We’ve only got to make it until next Wednesday, and then I can start taking the new medicine. Zelepar, a special form of the medicine called Selegiline, is a different type of Parkinson’s medicine entirely. It is an MAO-inhibitor. I’ve read what that means a dozen times now, but I still don’t understand it well enough to put it in my own words LOL.

The reason Dr. S. is trying this particular prescription is that it dissolves on the tongue and does not go through my digestive system. It goes straight into the blood stream. With the improvement in stomach comfort that I’m seeing from the Miralax and glycerin suppository combination, I’m hoping this new medicine will be the perfect one for me for the time being.

I do know that at some point I will have to go back to taking Sinemet, which was the first medicine I took. It nauseated me, too, but I’ll cross that bridge when I get to it, because there is a patch form of it in drug trials now.

So for the next few days I’ll be weaving and lurching around here like I’m drunk, but I can put up with it, knowing there’s something new to try just days away. I am ever thankful to God that there are so many researchers working to find new ways of fighting the symptoms of this disease, working on ways to slow its progress down, and ultimately to cure it.

So I’m Stopping the Requip

Day by Day with a Movement Disorder Posted on by 1

I went to my Neurologist today, and we discussed my digestive problems, hair loss LOL, and insomnia. His solution was to taper off the Requip until I have quit taking it completely and see what happens to my stomach problems. He also gave me a prescription for a time release version of Ambien. And, of course, if it was the Requip that was causing the hair loss, stopping the Requip will take care of that situation.

I told him about writing to the National Parkinson’s Foundation “Ask the Doctor” site, and what that doctor suggested. So he’s given me some samples of the medicine the NPF doctor suggested I try. I’m not supposed to use it until I’ve completely stopped the Requip, if I can possibly stand it. But I explained we were taking care of my Daddy, and I might not be able to put up with my impaired walking that long. He wants me to try, so he can get a fair assessment of how the new medicine works, but he does understand our situation.

He gave me samples of Zelepar, one of the brand names of Selegiline. It dissolves on the tongue, so it does not go through the digestive system at all, but straight into the blood stream. I have high hopes for this medicine. It is also a different type of medicine than I have had before. This one is an MAO inhibitor. I’ll have to do some research to fully understand what that means.

I am very thankful that all the research over the last few years means there are a lot more different types of medicines for him to try on me than there used to be for Parkinson’s. None of them slow down the disease, or do anything at all to cure it, but they do help with the symptoms. For now, that is a blessing. Hopefully, in my lifetime, they will find ways of at least slowing the disease down. And who knows, maybe they’ll even find a cure.

Doctor Recognized My Symptoms

Day by Day with a Movement Disorder Posted on by  

I went to my Gastroenterologist today, and I went into some detail about the stomach and general digestive problems I’ve been having for some time now. He recognized what I was describing, and even had a worksheet of instructions already printed up with how to deal with my set of symptoms. He definitely said this problem was caused by my Parkinson’s medicine, Requip, and not by the Parkinson’s Disease, itself.

I was correct in my guess that my digestive system had basically quit moving things along, but apparently wrong as to the reason, as I thought it was the PD causing it.

Anyway, he assures me I will be feeling much better in a few days, and I’m to call his nurse Monday with my progress report. Hopefully, I will have a good report for her.

Daddy woke up this morning barely able to balance well enough to sit on the side of the bed without falling back over. It was much harder than usual to get him dressed, and I was glad when DH got there, so he could help me walk him to the kitchen for breakfast. By then, Frances had gotten there, and we cautioned her that he was very unsteady. When we got back this evening, she said whatever was going on earlier had passed by mid morning, and the rest of the day was normal. I don’t know if he had another little stroke in the night or not, but he sure was different for awhile this morning.

I’m very thankful I have someone I can leave Daddy with that I have confidence in. Otherwise, I probably would have postponed my own appointment today, and that would not have done either one of us much good.

Requip and OCD – a Serious Side Effect

Day by Day with a Movement Disorder Posted on by 2

One of the side effects of dopamine agonists, the kind of Parkinson’s medicine I’m on (Requip), is that they cause excessive gambling. Some people have lost their whole nest eggs before their families realized what was happening.

Well, I don’t gamble, as a matter of religious beliefs, so I don’t have to worry about that particular problem, but the underlying symptom is something I’m beginning to show signs of. Gambling in and of itself is not the real issue, but compulsive behavior, or OCD. It shows up in some Requip users as compulsive shopping, instead of gambling.

With me, I’m having a harder and harder time pulling myself away from the computer. Those of you who have come to know me online know just how much time I spend here, and would probably agree it’s too much, and you don’t know the half of it.

Now that I’ve admitted it out loud, so to speak, I’m going to have to discipline myself and put some limits on my computer time. I’m not sure exactly how to do that yet and still take care of our online business, my blogs, and the BLOG VILLAGE TopList, plus keep up with a few key sites I’m involved in, but I’m going to have to try. I know I check my email way too often, and check the forums too frequently, so that’s some place to start.

Have any of you dealt with OCD? Is this something I can do on my own, or do I need to let my doctor know I’m showing compulsive behaviour? I’d be interested in hearing what you have to say about this.

Another Great Day!

Day by Day with a Movement Disorder Posted on by  

We had a wonderful Date Day yesterday, with beautiful Fall weather, and some really nice finds at a handful of garage/moving and Estate sales. Because of the direction we headed, DH didn’t have to deal with horrible Friday afternoon traffic when it was time to head home, like he usually does, so that made it even better.

We ate out at a buffet, so I was able to find plenty that I could eat, while he could get what he wanted. I’ve gotten in the habit of taking a couple of Beano caplets before I eat, anytime I even suspect that I’m going to eat something that might produce gas, and that seems to be helping, too. All and all, I seem to be settling into a pretty good idea of how to eat in such a way as to protect my stomach, as things have been pretty calm for several days now.

I wrote to the Ask the Doctor mailing list on the National Parkinson’s Foundation site last week, and my post showed up in the email today. It takes about a week between sending in a question and getting an answer, as these are practicing physicians, who take the time to answer the questions. I had asked the mailing list doctor if he could suggest any meds that I could take in patch form, to bypass my stomach.

The doctor suggested I try the form of Selegiline, called Zelepar, that dissolves under the tongue and bypasses the stomach, and also go back to Sinemet, with a larger dose of Lodocyn. According to him, Requip causes more nausea than Sinemet does. My Dr. S. had said he couldn’t promise that the Requip wouldn’t make me more nauseated, but that he wanted to give it a try.

So, for now, at least, I’ll stick to the Requip, but if the nausea and bloating start up again, I think I’ll make an appointment with the Neurologist for as soon as possible, and see what he says about the Parkinsons’s Foundation Doctor’s suggestion.