Tag Archives: Zelepar

Sitting MRI and a Full Night’s Sleep

Day by Day with a Movement Disorder Posted on by 2

Well, I had my Standing MRI on my neck yesterday. I was having some strong tremors when I got there, so the technician changed it to a Sitting MRI! LOL!! He also put a lightly restraining halo on my head, and I managed to stay still through the whole 30 minutes. He said I did just fine.

Of course I won’t find out anything until next week probably. I’m guessing that he will prescribe Physical Therapy again, particularly since I had such a terrible reaction to the Celestone steroid shot for my poison ivy. It depends on just how much damage he sees, I guess.

I have my Neurologist appointment next week, so I will be talking to him about how I should proceed. He may have me stop taking the Zelepar, as that seems to be the med that gives me the most interaction warnings. It does not play well with others!

I have an appointment with my Sleep Apnea Specialist next week, too. He should be dismissing me, hopefully. I am sleeping a full 8 hours almost every night now. And it has made a miraculous difference in my daytime sleeping. Actually, I’m not having ANY daytime sleeping problems, now. I can ride in the car for hours now, and still carry on a conversation with my DH. It’s been years since I could do that. No more jerking awake at the computer from a few seconds of sound sleep out of nowhere. And, I am still on the Requip that gets blamed for this side effect. It wasn’t the medicine after all for me. I was just sleep deprived!

It’s so gratifying to see improvement even in one area of my health. And I have high hopes that Dr. J will fix the pain and stiffness in my neck.

Drug Interaction Still Causing Problems

Day by Day with a Movement Disorder Posted on by 10

I went to the Gastroenterologist Wednesday afternoon, and he did X-rays of my abdomen to determine if I was as constipated as he thought I would be, based on my symptoms. He was surprised to find that nothing in my colon was hard or compacted. After examining me, he has come to the conclusion that my problem is caused by spasms of the digestive tract, rather than weak muscles, as he had been telling me it was. So, now he thinks my trouble is exactly the opposite of what he had thought previously!! He prescribed Triavil, which relaxes the colon muscles, and he said I should feel much better by Monday.

I’ve learned my lesson though, so I specifically asked him if he was sure I could take this med with my Parkinson’s meds. He said he did not think this would be a problem, but to ask my pharmacist. Full of hope that he had found a way to stop my very uncomfortable situation, I called our drugstore on the way home to be sure he had it in stock. But, when hubby came back from the drugstore, he didn’t bring in the prescription bag. He said the pharmacist said his computer all but crashed when he put in the medicine, it produced such a strong warning that this was a dangerous combination with my other PD meds!!

At first I handled the news stoically, but later on that evening I went through a rough time of being very depressed, with lots of crying. I called my doctor’s nurse first thing Thursday morning to let her know I couldn’t take it, and to remind her that he would see Selegiline listed in the interaction information, rather than Zelepar, which is just a dissolving form of Selegiline. I think that must be why he didn’t realize I couldn’t take it.

Anyhow, I haven’t heard back from him yet, so DH and I decided it was time to take matters in our own hands. We went enzyme, herb, and spice shopping, as I have been doing some research on my own about Irritable Bowel Syndrome (IBS), and I found some things that should help, without causing problems.

Yesterday, I started taking Turmeric, St. John’s Wort, and Acidophilus capsules. DH’s Oncologist has had him on Turmeric ever since he had colon cancer, and his doctor had already suggested I use it. We had our usual Date Day today, and I continued to belch a lot all day, but did not have any nausea at all, or my usual sensation as if my food was sitting at the top of my throat all day. I’m encouraged that I will find a way to calm my system down and get things back to closer to normal, whether my Gastro can find a medicine I can take or not.

I’m still very wobbly, though, so I used the cane just about everywhere we went today, and I’m using it in the house tonight, too. It may be that it’s just going to take awhile to recover from the really bad state I was in Sunday, plus I may still have some of the Cortisol in my system. I’ll have to see if I can find something about how long it stays in the system after getting an injection. Or, it may be that the St. John’s Wort, added to my other PD meds, is giving me an overdose of Levadopa.

That’s what makes figuring this all out so difficult, as too much PD meds makes for jerky movements, called Dyskinesia. If you’ve seen Michael J. Fox jerking around, you’ve seen it. When PWP have been on meds for a long time their systems process the Levadopa in a very unpredictable way, and you see these wild jerking movements. But early on, if the meds aren’t strong enough, you see tremors. It’s hard for me to tell if my wobbliness is tremor or jerking, so I can’t tell, based on that, if I’m getting too little or too much Levadopa. My hands are only shaking ever so slightly, which makes me think I’m not getting too much. My Neuro will know when he sees me.

By then I should have heard from my Gastro doctor, and I’ll know if the herbs are going to do any good or cause any problems. I will be doing more research, too, to be sure there are no contraindications of these OTC with my prescriptions.

Tummy in Rebellion

Day by Day with a Movement Disorder Posted on by 6

Warning: This post is not for the weak stomached!

Today did not go well at all. I followed my list of med times, trying to spread out all the doses as much as possible. I was careful to take the ones that needed to be with food, and the one that needed to be without food at appropriate times.

Before I could finish sipping my hot tea this morning after breakfast, I moved to get up from the sofa to go to the bathroom, and all the liquids I had taken in over the last hour – juice, water, and tea – all came up explosively all over me and the sofa, propelled by all this gas I have. It’s as if my stomach is stopped up at the bottom and couldn’t hold it all. That is called Gastroparesis, which means slowing of the emptying of the stomach, and is quite likely part of my problem. Really, every part of my digestive tract shows signs of weakening, so I shouldn’t be surprised when something like this happens. That didn’t make it any less upsetting, though, as DH had to quickly do a wash before all that acid ruined my clothes, while I took a bath, and we had to try to get our sofa cleaned up, too. And, I’ve stayed nauseated most of the day, just as I did when I tried to take Sinemet last year.

From what I’ve read from other PWP, many people get over the nausea fairly quickly when they start Sinemet, so I sure hope I will be able to tolerate it this time. I was much sicker with the GERD last year when I tried to take it than I am now, so there is reason to be optimistic, which is what I choose to be.

I see my Gastroenterologist tomorrow, and I have an appointment with my Neurologist next Friday, so maybe I will know what needs to be done soon to get the benefit, and not the side effects, of my meds.

Day One with Sinemet

Day by Day with a Movement Disorder Posted on by 6

Yesterday was the first full day of taking Sinemet again, as well as the Requip and Zelepar I was already on. I also had the Lodosyn and Sucralfate I requested from the ER doc, so that the Sinemet had a better chance of not making me so nauseated, the way it did last year. I started the morning hardly able to feed myself or walk, but ended the day almost back to my normal state. That was a huge relief, to say the least!!!

I also talked to my Gastroenterologist last night, but without any real conclusion to my gas and belching problem, or my elimination difficulties. He basically just asked me a lot of questions, most of which I could not give him any clear cut answer to, and told me to go on and make an appointment with him. I told him about the ER trip, and how I had been delaying my Neuro appointment, waiting for a diagnosis. He said to go on and make the Neurologist appointment, so I’ll do that today. The fact that he has taken so long going over all the diary I gave him, plus his obvious quandary as to what is going on, leads me to think that a serious diagnosis is not jumping out at him as likely. That is what I’m going to assume, anyway.

The comical part of all this was trying to figure out a schedule to add in three more meds, taking into account all the restrictions on timing and eating and nearness to other meds that each one has. I finally wrote out today’s schedule, and I’m taking one or more medicines today at 5AM, 6, 7:30, 9, 11, 12, 1:15, 3, 5, 6:30, and 8PM! And that doesn’t count the Myralax that goes on my cereal or the glycerin suppositories I use! You should see the size of my pill boxes!! Oops, my timer just went off…. time to go take medicine LOL!

Well, I’m back. I just took the Sucralfate, a hog pill that I had trouble swallowing yesterday. Last night we cut it in half, but I still choked on it, because it’s so dry going down. So, this morning I soaked the two halves in a tablespoon of water, and swallowed that. That was much easier, although I can still feel the dry scratchiness down my throat. That’s one of my new stomach protector meds, so I have to take it, uncomfortable or not.

Each day is a new adventure with this PD, with some days being hopeful and others being miserable. Thank goodness I don’t often get as down as I was Sunday night. I thank God for that!! And, I thank you for caring enough to say an encouraging word, too, as I surely need it.

Can’t Take Meds I Used to Take

Day by Day with a Movement Disorder Posted on by 6

I’ve been working out in the yard a good bit lately, as part of my exercise. I’ve made some headway with our yard, but I’ve also come in contact with poison ivy somewhere along the way. I am extremely allergic to it, so I’m broken out over a large part of my upper torso, front and back, on my neck and face, and even in my hair. I have no idea how that happened. We have new cats outside, too, and I may have picked it up cuddling them.

So, I pulled out my trusty Benadryl, in addition to the topical anti-itch meds I always have on hand. Benadryl makes me sleepy, so during the day I’ve always used something like non-drowsy formula Sudafed. When DH went to the store he couldn’t find the exact same Sudafed I was about out of, so he took what appeared to be a similar medicine to the Pharmacist to make sure it was OK for me to take it. He made sure he told her I had Parkinson’s, and she said it would be fine.

I hadn’t even thought about checking for PD drug interactions, so I’m glad hubby did. Particularly since I did take one dose of the 12 hour Sudafed with Pseudophedrine Hydrochloride in it this morning, and I’ve felt yucky all day long today. When I looked on the new box to see how many to take, despite the fact that DH had asked the pharmacist if it was OK, there in fine print, among the list of conditions that made using it unsafe, was – you guessed it — Parkinson’s. The same warning was on my old box of meds, too, and I hadn’t even thought to look. That’s BAD.

So, I called our local Pharmacist to double check, and sure enough, I can’t take it. DH has gone there now to get Chlorotrimiton, which has nothing but an antihistamine. It doesn’t have any decongestant in it. My Zelepar is in the MAO class of drugs, so I have to pay attention to things like that.

As careful as I am to check on drug interactions with prescriptions, it never occurred to me to check out these over the counter meds, as I’ve taken this combination for poison ivy for years. BAD GIRL, BAD GIRL!!

I’ve hopefully learned my lesson, though, and will not let old habits take over again. Cause the old gray mare ain’t what she used to be!!

No Surgery After All!! WHEW!!

Day by Day with a Movement Disorder Posted on by 9

I made the rounds of my doctors again yesterday, and the specialist my Gastroenterologist sent me to does not believe that my situation warrants surgery at this time. He would rather I continue to use all of Dr. B’s arsenal of Bowel Retraining routines – glycerin suppositories daily, Milk of Magnesia every couple of days, bran cereal and prune juice daily, Miralax, and Amitiza. He also went over the list of what I can’t eat again, and it seems to get longer each time I see him.

I’m not allowed to have

soft drinks of any kind
chocolate
nuts, particularly peanuts
any dairy products at all
cruciferous vegetables, such as broccoli or cabbage
beans
tomatoes
coffee
caffeine of any kind

And no telling what else that I can’t think of right now.

It’s hard to believe it takes all that to keep my system from bloating, but it does. Zelnorm was much better than Amitiza at producing a stronger muscle contraction through the digestive tract, but I’ll just have to make do with the Amitiza, and hope they find a way to modify the Zelnorm and get it back on the market.

There’s now an agreement among the doctors that my elimination problem is due by and large to the weakness of the digestive tract muscles, caused by the Parkinson’s, rather than the anatomical problem that was recently discovered.

I liked this new doctor. He explained things very well, and took a lot of time with me. He explained why he thought surgery would be unlikely to have much of a chance of improving things at this time, and he also gave me some idea of what to watch out for, in case the problem worsened. I will see him again in 6 months, assuming all goes well.

I saw Dr. B, my Gastroenterologist, too, and he wants me to use the full complement of Bowel Retraining strategies for a week. If I am still bloated and having problems with gas and elimination, he will do another colonoscopy. I had one a year ago, with no polyps or other problems, so he really doesn’t expect to find anything. But he knows I’m concerned, and the colonoscopy will ease my mind.

So, with no surgery in the near future, I can stop spending so much time on the computer, reading everything I could find about this problem. I really was beginning to obsess over it, but I learned a lot. I was extremely pleased that the surgeon pulled out his huge PDR and looked up the interaction between Zelepar and Demerol as soon as I mentioned I had read about it. He agreed that I could not have the Demerol if I had the surgery. I will DEFINITELY have to get something in my wallet TODAY to that effect. If I somehow ended up in an emergency room, needing immediate surgery, my own meds could possibly kill me!! So, doing the research was worth it, if only for learning that one piece of information.

Hopefully this is the last time for a long time that I need to discuss my bowel habits LOL!! I’m sure anyone taking the time to read my posts is tired of hearing about it, as I’m tired of having to deal with it, too.

6 Doctor Visits in 6 Days!!

Day by Day with a Movement Disorder Posted on by 4

We have kept the roads hot this week, going from one doctor to another, even seeing two doctors twice. But at least I have a better idea of what’s going on with several different problems I have been having. I saw my Gastroenterologist twice, and now he has me scheduled to see the doctor he wants me to use for the surgery I need to correct the problem with my digestive system. I was really upset about having to have surgery at a hospital I don’t like, if my own doctor performed it. Now I can quit stewing about that. Dr. B solved that problem by telling me that he coordinates for this surgery with this particular doctor, who uses the hospital I like.

I saw the Sleep Specialist twice, too. The nights at the Sleep Study were not pleasant, as I was very uncomfortable in the bed, and the thing they had in my nose felt horrible. Halfway through the night, I got so upset about how miserable I felt that they changed to a different type of mask, and I got through the rest of the night fairly well. Tonight will be my first night to sleep at home with the C-Pap. Wish me luck!!

The tick bite looked really fierce for a few days and itched something awful, but now that I’ve been on the antibiotics since Friday, my left knee no longer looks like it’s getting worse, and has stopped itching.

The Amitiza has turned out to be a good substitute for the Zelnorm that was taken off the market. I’m very pleased with how much it is helping with the constipation problems.

I’ve been reading everything I could get my hands on about the surgery I am to have, and I discovered that I cannot have Demerol if I stay on my Zelepar. I talked to the Sleep Specialist Doctor about what I would need to do about the Apnea when I have surgery, and I talked to him about the Demerol interaction I had discovered. He suggested I might want to tell them that I was allergic to Demerol, so it would be marked clearly on my chart and they wouldn’t dare give it to me. The combination is extremely dangerous, so I might as well be allergic to it, right???

Now the only thing left to do is to make an appointment with the Orthopedic doctor, so I can get another cortisone shot in my right knee, which has arthritis in it. I don’t want to be hobbling around the way I am now, trying to recuperate from major surgery!

Starting Requip Again – Stopped Physical Therapy

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Yesterday was my last time for Physical Therapy on my knee for now. I called my insurance company, and they only allow 15 PT visits a year, unless THEY approve the extra ones, and I’ve used 7 of them already. So, I figured I’d better leave myself with some, in case I have other problems before the end of the year.

I asked her about using the mini trampoline we have, and also a little stepper and an exercise ball. Her concerns had to do with balance, but other than that, she thought they would be fine. She said the stepper was a particularly good one for a PWP, because of the repetitive alternating motion. Of course she cautioned me to go slow about adding minutes to it, and to rest every other day or every two days. She’s very emphatic about reminding me that the Parkinson’s means I have to rest my muscles more than other people would need to. But she emphasized that I need to be on a regular exercise program the rest of my life.

I did start on the Requip again yesterday. Even though I’ve been doing all this exercise and my legs are definitely stronger, I’m still walking very slowly. It’s called Bradykinesia, and it’s always been my main Parkinson’s symptom. Requip has some pretty uncomfortable side effects, as most of the PD meds do, it seems, so I really tried to do without it. But I just don’t think the Zelepar is enough on its own. Dr. S. told me to use my own judgment on starting it back, so I’ve decided it’s time.

I did get nauseated before lunch yesterday and I had a headache last night. Plus, this morning, I got light headed while I was taking pictures for our eBay listings. I stood still too long, I guess. Anyway, I had to stop and sit down, as I broke out in a cold sweat and could feel myself getting woozy. The worst side effect for Requip, though, is compulsive behavior – if that starts up again I won’t be able to use it, for sure.

The PT worked me pretty hard yesterday, knowing it was my last visit, and I was very uncomfortable last night. I ended up taking 2 Lortab to stop the pain in my legs. At least that meant I got a good night’s sleep! They don’t seem to be as sore today, so that’s good.

I’m having the MRI today at a different place, called a Stand Up MRI. That will be a new experience. It makes me wonder if that was chosen to get a different view of my knee, as there is a regular tunnel MRI place in the same building with my doctor.

I just realized that I forgot to call the Orthopedist’s office yesterday to make the follow up appointment. I’m really having a hard time remembering to do everything that needs to be done nowadays. Hubby tries to help me keep it all straight, and I make lists like crazy. I’ve even started using the task reminders on my Outlook program to try to help. Of course I have to remember to put the reminders in the program LOL!

I got an email from the other PT patient who has Neuropathy last night, and of all things, we live in the same town!!! I’ll be doing some research on her particular type of Neuropathy and adding links to it, if I can find anything specific for her. I wonder if she lives anywhere near the EPA toxic site, the way we do????? She’s in far worse shape than I am, and the doctors don’t know what’s causing her problems, either. And she’s young. I’ve added her to my prayers, and I hope she and I can continue to correspond.

It was a day of changes yesterday, but hopefully they will be good changes. Only time will tell.

Getting Back to Normal?

Day by Day with a Movement Disorder Posted on by 6

I’ve gotten a lot done in the last few days. We’ve had the appraiser out to the house, the taxes are ready to sign and mail, and I’m almost finished with the tax bookwork for our paid caregiver. I finally gave up and went to the Orthopedist about my knee and shoulder, too. The X-rays showed the degenerated cervical disk I already knew about, and arthritis in my knee, which wasn’t surprising. Dr. J is guessing that I have a torn miniscus, but it will take an MRI to determine that. From what I’ve been able to read on the Internet, that seems like a reasonable diagnosis to me, particularly since it was injured when I was shifting Daddy up in the bed.

I’ll have to go to Physical Therapy and stay on Extra Strength Tylenol 3 times a day before my insurance will agree to the MRI. That’s fine with me, as far as the therapy goes, as I’m sure it will be helpful. The Tylenol doesn’t even faze the pain, but I’m following his directions and taking it regularly.

We’re still walking at the track early in the mornings, but it’s been way too cold the last few days. Alabama is having record cold weather right now. So, we’ve been doing exercises from videos. DH is REALLY following the tape, and I’m bouncing on one of those little trampolines and doing as much of the arm movements as my shoulder will let me.

I’m still just taking the Zelepar, hoping that the exercise and whatever the doctor does for my knee will be enough. I just don’t want to try the Requip, if I can possibly help it.

We had our usual Date Day Friday and enjoyed looking at lots of Estate Sales. We’ve never been able to be an Early Bird before! It was strange to get there before most of the stuff was gone. And we did manage to pick up a few good buys, I think.

It’s been ages now since I’ve taken pictures and put anything on eBay, but I’m going to try to get back to that this week. We have an almost overwhelming amount of “stuff” we’ve bought in the last few years, and I haven’t been able to work seriously on our online sales for almost 2 years. With so much of the Estate business started now, I’m ready to get back to NORMAL.

Lots to Do Settling Daddy’s Estate

Day by Day with a Movement Disorder Posted on by 12

This is the second time I’ve been the executor of an estate, but Daddy’s is much more involved than Pop’s was. Luckily, we have a niece who is a lawyer, so I’ll have some help when I’m ready. I’ve tried researching what I need to do on the Internet, and I’ve been surprised at how little help I could find. Everything seems to be geared toward Estate Planning, rather than settling an estate.

April 15th is getting closer, too, and I’ve just not been up to dealing with important numbers. I did get a good start today, though. Starting is half the battle for me, as I find I’ve become quite the procrastinator in the last few years. I don’t know if that’s a sign of old age LOL, stress, or Parkinson’s!

We walked again this morning, but I was slow as mud. I made it around for a half mile, using the walker. I’ve been using the walker all this week, but I depended on it more today, as I could feel the tightness in my shoulders when I stopped. That slow as mud feeling is the first Parkinson’s symptom I had, so it’s looking less and less like I’ll be able to continue on just the Zelepar. The Neurologist told me I could go back on the Requip as well, if I felt like I had to. I’ve resisted, because the Requip gave me stomach troubles last time. Well, I had stomach trouble when I was on the Requip – that doesn’t automatically mean the Requip was causing it. It’s that uncertainty that has kept me trying to do without it. I’m just not ready to cope with stomach side effects yet. Maybe next week.

I taught 4th and 5th graders for 25 years, but I’ve seen the “Smarter than a Fifth Grader” TV show a couple of times since I’ve been back home. It’s scary how much my mind goes blank on stuff I know I should know. I hope it’s just remnants of caregiver burnout, and not the PD effecting my mental abilities. Stress can really do a number on such tasks, so I’m trying really hard to relax as much as I can. But getting things accomplished is part of what’s needed to lower my stress level, too, so it’s a matter of finding a balance, I guess.

I continue to be uplifted by all the loving comments. You all really are helping. Just a thought for you, if you need to send a sympathy card to someone. One of our friends included a neatly cut out copy of Daddy’s Obituary notice in their card. It was very much appreciated.