The Risks and Benefits of Parkinson’s Medications

[paul-d-lefebvre]

In retrospect my symptoms began in the summer of 2006. Eventually, the impact on my movement ability, as well as the increase in tremors and the change in my handwriting, moved my to get an evaluation and I was diagnosed in August 2012. I began immediately to read what I could find on the disease, and that included several writings that talked about the growing ineffectiveness and adverse effects of levodopa/carbidopa over time. So I resisted medication. But after 18 months, I realized that especially the tremors were becoming unbearable. I went in for another evaluation and came away with a Rx for Sinemet. I have had one increase in the dosage, and am now at 7 pills/day.

I only know the risk of Sinemet from what I’ve read; I don’t believe it has yet had an adverse effect on me. On the contrary, I do know that my symptomatic tremors (internal and external) seem to respond well to the medication. I supplement the medication with physical activity (forcing myself to move) at the gym (YMCA), bike riding and outdoor chores (cutting the grass, shovelling snow, etc).

Despite the positive response to medication, I do sense the predictable progression of the disease.

[Deleted User]

Paul, I fought the PD medication battle with myself (I have written 4 articles about my struggles with medications and alternatives,   https://parkinsonsnewstoday.com/category/slow-is-the-new-fast-a-column-by-jean-mellano/)  Finally I succumbed and take 6 Sinemet/day and I no longer have internal tremors.  But, is that because of the Sinemet or exercise, diet, etc or a combination of all 3?  This makes life with PD so frustrating for me; not being able to definitively figure out what is providing me symptom relief..

[paul-d-lefebvre]

Yes. I often wonder about the value of exercise, for instance, especially when it leaves me depleted. But then I wonder -both out loud, and to myself- ‘what would I be like without it’? ~~ It’s good to hear that you are not now bothered by internal tremors. That’s a relief whatever the cause.

[Deleted User]

I believe exercise and movement are key to battling this disease, however what I struggle with is the intensity and frequency.  Some studies show high intensity exercise is the way to go, however, I am usually so exhausted, that when I push myself, I become depleted as you say.     Is more necessarily better?

[paul-d-lefebvre]

I have read similar about intensity and frequency, and I get the same results you do. My working theory now is that I will work hard enough to get a good sweat to ensure I’ve pumped some new oxygen through my body, and then be done.

[Deleted User]

I find my working theories must be flexible LOL…. Today, I had to force myself to exercise, not a good PD day.  I was exhausted before I even started.  I have these internal arguments, “push, keep pushing” vs. “back off, back off”  Some days I do push when I feel like these, other days I don’t.  Today, I pushed to complete my planned workout.  One thing I must constantly remind myself of, I am no longer the athlete I used to be.  🙁

[paul-d-lefebvre]

That “I am no longer the athlete I used to be” is a very difficult admission, even -or, especially- to our self. It dissolves some of the glue of pride that held us together over years of living and aging. Even if a person was never an athlete, to say “I cannot do the things I used to do; things that made me Me, showed my accomplishment”, is a bummer of one’s pride of Self. ~~ But you’re right, Jean, we do need to be flexible and remember those bits of glue, of pride, were inculcated in us at a time when they fit the Self. PD working its way in upon us really creates a whole other Self, and we need to find (be flexible) other ways of being that support our value. ~~ At least that’s what I think.

[Deleted User]

Very wise words Paul, thank you for sharing your thoughts.