Tummy's Back to Normal - PT Continues

It took a couple of days of very careful, limited eating, to get my tummy back to a normal situation, but I'm much better now. I've gone back to using the glycerin suppositories, and that's helping the most, other than to avoid some questionable foods.

I talked to my PT Monday, and told her my neck was much better, and that I was surprised they had not had me doing any exercises. She said they wanted to get my muscles calmed down first. So, she is going to add some tomorrow. I told her I wanted to be stingy with my visits, in case I needed to come for something else later on in the year, so she has me on Monday and Thursday now, instead of 3 days a week. Of course, that frees up our Date Day, and that suits me just fine.

I've been extremely busy trying to help all the families who have been asking for help find lost lovies, ever since the msnbc.com article came out about our Plush Memories Lost Toy Search Service. We had well over a thousand hits that first day, and our traffic is still about double what it was before the article.

I'm fighting the poison ivy again, and I'm not sure which one of us is winning right now. I have found that I can take one Benadryl at night, and that stops the itching until in the afternoon. Then I take a non drowsy type that the pharmacist said I could use. It doesn't work all that well, and by early evening I'm in misery. It gets in my blood stream or something, because I end up with rash and blisters in places that it should not be. Very delicate skin itches ten times more than arm or leg skin, I guarantee it!!!

I see the Dermatologist in another couple of weeks, so I will certainly ask him about anything I can do to dry it up quickly.

I think I know where the poison ivy is coming from. We've been bringing our outside cats in at night when the weather is below freezing. I am pretty sure I'm catching it from them. We had the brother and sister kitties neutered last week, and the little girl is somewhat frail, so we did not want to take any chances with the cold. The only other possibility is that the wood chips I'm using for the compost have the vines ground up in with it. Our back yard is just full of poison ivy, so that's certainly possible.

I'm continuing to limit my reading of anything Parkinson's related, but nothing has changed as far as my foot tremors and facial tics go. Oh, and I still haven't started back using the TAP. I decided to get my neck calmed down, plus see if the mouth tic was related to maybe my tongue moving around on the inside of the mouthpiece in my sleep, and it getting to be a habit. Well, the neck is calming down nicely, but the mouth tic is still there. So I think I can stop blaming the TAP for that.

Since I've been taking the Benadryl at night, I'm sleeping quite well, even without the TAP. Funny, the Benadryl is working much better than all the fancy sleep meds ever did, and I've tried almost every prescription they make at one time or another.

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.

Going Through a Depression Phase

I have really tried to stay positive about all that's been happening to me over the last year or so, but I'm not succeeding very well right now. When I went to my Neurologist last time we made a point of telling him that I was crying extremely easily over just about everything. He had a name for it, but it was a mile long, and I forgot what it was. Since he said he didn't want to change any medicines until after I've had the sleep study, there didn't seem to be any point in pursuing it, as long as we've told him about it.

We've been waiting to get the garage we're having built finished. We waited an extra month for the siding and roofing to be special ordered to match the house. Neither one of them is a match - right color, but wrong shapes. And we're stuck with them. That set me into quite a blue funk for the last few days, but I'm getting over that. It's just a garage. Sometimes it's hard to keep perspective about things like that.

We're still dealing with estate business, so that doesn't help with my state of mind right now, either.

I started back on the glycerin suppositories today, as I have gradually had more and more trouble with bowels again. Just as before, there's nothing that would make me consider myself to be constipated, but my muscles just don't push hard enough. They took the Zelnorm off the market that dealt with that problem for me before. So I'm planning on going back on the Bowel Retraining regimen.

So, with the insomnia continuing, the bowel situation flaring up again, and just generally too much going on, I've had better days.

We Have BOOTIES!!

Finally, a good two weeks or more after I first asked for them, the nurse brought the sheepskin looking booties today. If I had gotten them when I asked, his heel would not have looked so bad, and may not have even blistered at all. She also brought the seat cushion for his chair. His bottom is also getting worse, so this will help considerably.

We spent the whole morning trying to achieve a bowel movement. I've been giving Daddy 2 stool softeners with each meal, plus a Senna laxative tablet each night. He hadn't been since last Wednesday, so this morning we went all out to get some results. Prune juice for breakfast, plus another laxative tablet. It's quite an involved process to get him in the bathroom now, but DH helped me this morning. Daddy still couldn't go. So, I used a suppository. We waited, but still nothing.

By the time we had him ready to move to his chair in the living room, everything decided to start working. So, we went through the routine to get him back in the bathroom, take care of that, and then put him on the bed, so I could get him really clean and put ointment back on his sores. Then, we got him back up and into his chair. By the time we did all that, the nurse came. His chair is a recliner, which he would not use before. But we had so much trouble keeping him comfortable in his chair or the wheelchair Saturday, that we thought it was worth a try. By propping his calves up with two pillows, we finally got his legs high enough for his heels to hang without touching anything. And he's comfortable. He immediately fell asleep, bless his heart.

He's not the only one who's worn out! DH had to take over and sit with him while we were waiting for him to finish in the bathroom, because my stomach started churning and cramping. I not only had diarrhea, but I came very close to throwing up. I think it was just from my nerves, but this would never have happened before I had Parkinson's. It makes me so very nervous to work with him, because I'm so slow at everything I do. I'm afraid he's going to fall while I'm trying to get his pants down. In fact, I'm afraid he's going to fall every time I do anything with him. Really, I'm just afraid, period. Even though I know exactly what I want to do, I have no confidence that I will be able to actually do it, anymore.

DH and I have eaten lunch, but we've left Daddy sleeping for now, as he's exhausted. DH is asleep sitting on the sofa, and I'm blogging and resting. We're all three worn out from the morning's doings. LOL

This nurse says the other nurse will bring the air mattress when she comes later in the week, which should help his bottom a good bit.

I managed to control my temper while the nurse was here, as I didn't see that anything useful would come from letting her know just how mad at her I was. My DH knew I was mad, but I don't think she ever realized it. I hope not, as we have to work with her.

But if we have another situation develop like this one, I doubt if I will be so restrained.

Miralax, Zelnorm, Glycerin Suppositories Update

I just thought I'd been bring you up to date on how the regimen the Gastroenterologist put me on for constipation is working. I'm currently taking the Zelnorm in the morning at least 30 minutes before breakfast, and again in the evening. I sprinkle 17g of the generic form of Miralax on my high fiber cereal each morning. (It comes with a marked dose cup.) I can't even remember the last time I had to take the glycerin suppositories. The Bowel Retraining routine worked in about 10 days of using the suppositories at approximately the same time each day.

I'm no longer having problems in the bathroom, and have not had for some time now. I don't want to "jinx" it, but it looks like that difficulty has been overcome, thanks to Dr. B.

Strange Things Are Hapnin'

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 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.

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.