No Such Thing as Status Quo with Me

We had a wonderful Thanksgiving Day with our whole family. Our older daughter and her hubby both love to cook. So they went overboard with the food, but it was important to them, as their first big family meal in their new home. I could tell she was getting all stressed, which is not good for her at all, but I sure was glad I didn't have to have them all at my house. Don't get me wrong, I love being around all of them... but I get way too panicky at the thought of having that big a group all at once.

Plus now, my house is not clean enough for me to feel comfortable entertaining. I have started trying to unclutter some parts of the house, but it took it several years to get in this mess, and it's not going to be clean overnight. Hubby says to just ignore it .... something he seems to be able to do quite well. It bothers me, though. Every time I try to tackle it, I get worn out before I've made a dent! LOL

Anyway, I did have an appointment with my Gastroenterologist this week. I am still having lots of belching and gas, although the elimination difficulties have improved considerably since he put me on the Bentyl. I had read some things on the Internet that made me ask about the Metamucil and Glycolax, as far as were they contributing to the gas problem. I gave him the printout showing the times I was taking my meds, thinking he might see something that I needed to change. He was flabberghasted. He said he had no idea I was taking the Metamucil and Glycolax in the morning - that I should be taking them at night!

He also said the loud belches were from swallowing air. I told him I knew I did that when I took my meds with a big gulp, because I had trouble swallowing them. He suggested I take them in applesauce, instead of water. And .... it works! I do have a little trouble getting the swallow to come, though, thanks to my uncooperative tongue.

My tongue has started some kind of tic. I'm lip licking, or lip sucking, or moving my tongue around, rubbing against my teeth almost constantly now. I mentioned this new quirk in the PLM forum, and one of the Parkies said she had been rubbing the back of her dentures with her tongue for 14 years! She's actually worn a hole in the back side of two of her teeth!

Speaking of the TAP, I am continuing to get 7 1/2 to 8 hours of sleep each night. My alarm watch is waking me up now to start my meds at 5:00AM. If I could just stay awake later at night, I would change the time of the first meds. But it's all I can do most nights to stay awake until 9. I'm toying with the idea of taking a short afternoon nap, but I will wait awhile longer before I try that, to be sure I have the sleep habit well established.

I am out of the muscle relaxer meds now, but they really didn't help a whole lot to ease the soreness and stiffness in my neck. So I'll be calling my Orthopedist this next week.

I'm still having a lot more tremors than I had before my trip to the ER. The tremor in my right hand is unpredictable, but strikes often and hard. If I stand still for even a few moments, my right leg starts a little dance all by itself, making my whole body bounce, and sometimes now it starts up even when I am sitting down. That was only happening at church before, where I was blaming it on being cold and the seat being uncomfortable. Now it's pretty much a given that if I'm standing, I'm dancing, and if I'm the least bit tired or upset, I'm jiggling as I sit. And walking still feels like I'm on Jello. I'm using the cane all the time when we go somewhere now, except for church. I'm still stubbornly holding out on that, as it puts too much attention on me.

I am going to have to keep track of the times of the day that all these tremors start and stop, so I can tell if it has anything to do with my meds wearing off.

So today, I can give my sleep problems an A, elimination difficulties a B-, stiff and sore neck a D, and tremors a D.

No Surgery After All!! WHEW!!

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.

Digestion Problems Worsen

I have an appointment with my Gastroenterologist for this next week. Even though I have faithfully taken the Myralax each morning, take Metamucil every day, have been on the Bowel Retraining regimen, using the glycerin suppositories, and I've been really careful about what I was eating, I'm still having bowel problems. For lack of a better word for it, I would call it constipation, but it's more like the colon and rectal muscles just are not working properly. Before I was diagnosed with PD last year, I had a four month bout with diarrhea that was very difficult to stop. The Gastro treated me with the same meds that would be used with colitis and Irritable Bowel Syndrome, so that may be what's going on now. From what I've read, the IBS spasms can cause some really strange symptoms, which fit mine fairly accurately. I won't gross you out with any details. Let's just say things are not as they should be.

Other than that, I can report positive improvement with my right knee, which I had twisted again. We took off several days from the track, I have been staying on the computer more and reading more, and generally letting it rest. I did walk 1 quarter mile lap yesterday, and another today. Mostly I've been doing the exercises that the Physical Therapist outlined for me. I'm thinking I probably need to get some kind of knee brace to use in situations that might aggravate it, such as the clearing out I was doing of Daddy's things that set this episode off.

So, I wait for the Gastro appointment, look forward to the Sleep Study next weekend, and baby my knee while it slowly heals. DH, as always, has been super considerate. He keeps me laughing over his foolishness and does so much for me. No one could ask for a more loving and caring helpmete.

Sleep Continues to Be Scarce

The insomnia is continuing to bother me just about like it has been for several months now. I'm still having constipation problems, too. I've been on the Miralax continually now, but when I had to stop taking the Zelnorm, it began to gradually give me trouble again. I've been using the glycerin suppositories regularly now for the last week, but the problem isn't resolved yet. I'm already on a Metamucil capsule every day, besides the Miralax, so I hate to add any more oral medicine for it, for fear it will suddenly work too well. The only other Parkinson's thing that is going on with me right now is a very stiff neck. I have had like a crick in my neck now for several days, from a very tight muscle, that I just don't seem to be able to stretch out or limber up. I'll just have to keep exercising it, and hope for the best.

We had an absolutely glorious drizzly rain all day long yesterday, and I thank God for that. We need about a week of that kind of rain to make a dent in our drought situation, but it's better than nothing. Our grass finally looks like grass again.

They are supposed to come finish the garage tomorrow, but it looks like it might be raining. That's OK. We need the rain worse than we need the garage to be finished. We need to put another coat of water sealer down on the garage floor, anyway, before we start putting stuff in it.

Once we can use the garage for storage, we'll start bringing the furniture that our DD does not want to keep from their house down here. Also, we have stuff in our basement that we can't get to because it's in such a mess. Once we have a place to store it elsewhere, we can start emptying the basement of things and get the good stuff out of our way temporarily. Then we're going to have to make several trips to the dump!! We used to have a landfill dump here in our town, but it was moved to the other side of the county a long time ago.

That wouldn't have been so bad, but our town garbage collection rules call for household garbage only. They won't pick up anything that won't fit in a garbage bag. So, over the years, as things broke, like the washing machine, it just got stuck in the basement. Now we can hardly move down there. Oh, and the nearest Thrift Store won't pick up the appliances, either. There are certain disadvantages to living out in the boonies, that's for sure.

DH won't let me go down in the basement, as he's afraid I will trip over something or lose my balance trying to walk around all the stuff. I really do think he's being over protective, but I've done as he asked, and stayed out of it. I'm itching to get it cleaned out, though, and it bothers me that I can't just go down there and work on it if I want to. As it is, I'm stuck with his idea of when it will get done, and his timetable is a lot slower than mine LOL!! C'est la vie. That's what being married is all about - the give and take of blending two different people's habits and problem solving techniques together. I just need to work on my patience a little more, that's all.

Zelnorm Is Taken Off the Market

When I refilled my prescriptions last week, my pharmacist sent me a note that our insurance was no longer covering Zelnorm. I found out today why. It has been recalled. Luckily, the Miralax is doing a good job of keeping my digestive system moving along smoothly, and I didn't have any problems stopping the Zelnorm. Thank goodness I didn't have any of the heart problems that some people were having with it!!

That's twice my pharmacist has come to my rescue. I can't reinforce enough my suggestion that you buy all your prescriptions from one drug store!

A New Year & Renewed Hope

Today is the first day of a new year, and I must say, I'm glad to see 2006 over and done with. Not many years in my life have involved as many health related problems as last year did. My DH and I both had surgery, and our older DD spent months recuperating from Peripheral Neuropathy, caused by nutritional problems from previous Gastric Bypass surgery. I stayed with her each of the many times she went to the hospital, and I also stayed with her at her house, helping her with a gastric feeding tube, which did not work properly, and was eventually removed. On top of that, I was diagnosed with Parkinson's and Peripheral Neuropathy. And then, the day after Thanksgiving, my 101 year old Daddy fell from what must have been a light stroke. He can no longer take care of himself, so DH and I have been taking turns staying with him ever since, with the help of Hospice and a hired part time sitter.

So I have high hopes for this New Year of 2007. I figure it's time we had a quiet year. We survived last year, through God's grace, with our sanity more or less intact, but with our faith definitely stronger. What's that expression that Neiche(sp?) gets quoted on all the time? "That which does not kill us, strengthens us." I think that's correct, and I certainly believe it.

I'm still pleased with the combination of Miralax and glycerine suppositories, as my digestion PD symptoms have improved tremendously. Tomorrow is my last day to be on Requip, and then on Wednesday I'm going to start taking Zelepar. This is really the first time I've tried a Parkinson's medicine when my digestive system was settled down before I started taking the new meds. At least the Zelepar will have a decent chance of working, without tearing my stomach up!

So I start the New Year full of hope and expectation that it will be a good year.

Tapering Off Requip

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.

Miralax Effectiveness Evaluation Week 1

Miralax is a white crystalline powder that is mixed with a liquid and taken each day, one or more times, depending on the doctor's directions. Its purpose is to soften the bowel movement. It is also supposed to improve the effectiveness of Zelnorm, a medicine which helps to improve the rhythmic muscle action of the digestive system. I had read that it was supposed to be tasteless, but I frankly found that a little hard to believe!

I have been on Zelnorm for some time now, but my Gastroenterologist just added the generic form of Miralax to my prescriptions Friday. I tried dissolving the crystals in water the first time, and, at least for me, I will agree that it is tasteless. It does give the water a slightly thick feel, and I could tell it was going to turn me off of drinking water - a purely mental aversion, but one I needed to heed, as water is extremely important! So, I tried it in apple juice, and that worked for me. Then I got the bright idea to just sprinkle it on my morning bran cereal, since it really does dissolve completely. With a little stirring, it disappeared completely, and I couldn't even tell it was there. So that's the way I took it yesterday and today.

I didn't see any results at all from using it until the third day, and even then it was of minimal help. So, today I went back to using the glycerin suppositories after breakfast, and the combination was very successful. (I had stopped using the suppositories Friday, not knowing how my system was going to react to the Miralax.) The bloating has definitely gone down, as my pants are looser. I'm still belching as soon as I put anything in my stomach - even water - but it isn't as bad as it was.

Today was the first day in a long time that I didn't end up with the hot pad on my tummy, trying to ease the pain, so I can see the beginning of some improvement!

I'm sure everyone's experience with the effectiveness of Miralax will be different, depending partly on why they need to use it. But I can say that someone with Parkinson's, with a long term constipation problem, should certainly give it a try, anyway. The generic version is not very expensive, it seems to be gentle on the system and suitable for long term use, and it seems to do what they say it will do - all while being as close to unnoticeable as a medicine you have to drink is likely to ever get.

You will find a large number of testimonials about people's experiences with Miralax at the AskthePatient.com site.

A Quiet Christmas

We had a very quiet, uneventful Christmas today. Meals on Wheels always gives Daddy a Christmas present, but for some reason this year there were several. So we made a big deal of having him open them after breakfast. As usual, he didn't really show any emotion one way or the other, but that's just the way he is. DH had been recording all the Christmas TV programs he could find, so we watched the Mormon Tabernacle Choir, a fantastic bell choir, and a few other choirs today. Daddy slept through most of it. Both our DD's called, and Daddy talked to them a little. We got on the extensions and chatted with them for awhile, which helped me feel a good bit less lonely.

DH had bought the makings of a really nice Christmas dinner, so he and I put that together, plus some leftover cornbread and turnip greens Frances had made Friday. It was a really good lunch. We both nearly choked when Daddy told our DD's that we had leftovers for lunch!! He doesn't have a clue that he hurts our feelings with his lack of appreciation for anything we try to do for him. I should know better, as he's always been that way. I was always Daddy's little girl, always trying to please him, and never succeeding. I finally figured out that the problem was his, not mine, but even now, it still stings sometimes.

The Miralax is finally beginning to take effect, although I still spent a good part of the afternoon with the hot pad on my tummy, trying to quell the discomfort. Hopefully, in the next few days, I'll really begin to feel better.

All in all, it was not nearly as bad a day as I was expecting it to be, but certainly not as enjoyable a day as it usually is. Talking with our daughters and being with my wonderful hubby all day today made a huge difference for me. I also enjoyed emailing and blogging back and forth with several really great cyber-friends, who have a lot to do with me being able to stay upbeat most days. For that I am truly grateful.

So, yes, it was a quiet Christmas. We listened to a lot of beautiful music. We shared each other's company. We talked with family and chatted with friends. It was a good day, after all. Merry Christmas!

Parkinson's and Constipation

I feel like I ought to warn you that this post made me uncomfortable to write it, and it may make you uncomfortable to read it. It's not considered "polite" to discuss bathroom problems, and I understand that. So just skip this one, if you like. I'll certainly understand. But if you have Parkinson's, or know someone with Parkinson's, you might want to keep reading.

My Gastroenterologist has added Miralax to my Zelnorm prescription. He's recently started me on a regimen of daily glycerin suppository use, too, in what's called Bowel Retraining. I've already been on Metamucil capsules for several months now, and also eating a high fiber bran cereal every morning. The Parkinson's, or a combination of the PD and my meds, has left me with very little muscle power in my digestive system, plus diminished nerve awareness as well. He says that's where the bloating, nausea, and gas are coming from.

I am not allowed to have coffee, any caffeine drinks, carbonated drinks, chocolate, any dairy products - including cheese, any citrus fruits or tomato based foods, peanuts, drink liquids with meals, or eat anything within two hours of bedtime. And I'm sure I'm leaving something off the list! It seems like every time I go see him he adds something else to the list, anyway. Some things on the list are for my GERD, and some are for the IBS (Irritable Bowel Syndrome) symptoms he's treating.

Constipation is one of the most universal symptoms that people with Parkinson's Disease deal with, but, let's face it, it's not something anybody likes to talk about. But I want this blog to be useful to other PWP, so I don't want to leave out this information, even though I really don't like coming right out and admitting that I'm constipated. I really didn't realize I was, as everything seemed OK to me. But it's obvious to me now, after taking all these high powered medicines he's had me on lately, that I am, and have been for some time now.

Again, in the interest of being helpful to other folks with PD, I found this really well done site about constipation at MedicineNet.com.

Well, this was not an easy post for me to write, but I hope it turns out to be helpful to someone else with Parkinson's who's suffering some of the same symptoms I have been for so long. This is not a battle I have won, by any means. In fact, judging by the lack of success my doctor has had so far in dealing with my problem, I'm probably going to be dealing with this off and on the rest of my life. That's probably the case with most PWP, as well. If any one chooses to comment, I'd appreciate hearing what you have to say about how you've dealt with this problem.