PD Journal – 2016

3/5/16 – Nausea – 5 for days. Not as bad as it was weeks ago, but frustrating as it had been gone. Tremor in right hand still active, but not constant, estimate 50-70% of the time it’s present when I am at rest. Right hand is also markedly less dexterous and virtually incapable of repetitive motion (brushing teeth, salt shaker). Right leg still drags, constantly get’s hung up trying to get out of my Jeep.

2/27/16 – Increased Sinamet to 1.5 tablets, 3 x daily. Noticeable difference in nausea today. Nausea – 6 (had been 3 or lower for days) [Daily totals update:  262.5mg Carbidopa /  450mg Levodopa; 3mg Pramipexole; 1mg Azilect; 10mg Lexapro]

2/25/16 – With nausea virtually gone and me becoming more acclimated to the medications, there is no need at present to update this daily. Med changes, and other PD related phenomena will be noted here as needed and I will do a weekly wrap up like my old journal. This is where I will grant a window on life with Parkinson’s.

2/22/16 – Nausea:5! Much better! Still no difference in tremor. Might be a tiny bit smaller, but still constant.

2/21/16 – From here on nausea will be graded on a scale of 1 to 10. Anything less than 5 will have no effect on activity and 10 will be actually vomiting repeatedly (something I very rarely do regardless of how sick I may be). Nausea – 7.

2/20/16 – Replaced the Amantadene with Pramipexole (1mg 3 x daily) today. Pram was the first med that I was on but it had been losing effectiveness. I hope this reduces the tremor because if it doesn’t, next week i have to add 50% more Sinamet and enjoy 50% more nausea as well. Sure enough, adding the Pram back in today doubled my nausea. [Daily totals update: 225mg Carbidopa / 300mg Levodopa; 3mg Pramipexole; 1mg Azilect, all for Parkinson’s symptoms ; 10mg Lexapro for depression.]

2/19/16 – Made it to the gym. Only did my squats and just skipped the rest.

2/18/16 – Absolutely no way I could train today. Didn’t even think it was a good idea to be driving in this condition.

2/17/16 – Third day in a row I’ve given in to this nausea and lack of energy. Tomorrow I train no matter what the result.

2/16/16 – Mostly immobile from nausea today, tremor still unaffected. Very little food and no training today, now two workouts behind.

2/15/16 – Increased Lodosyn to 50mg per Sinamet dose bringing daily totals to 225mg Carbidopa / 300mg Levodopa. No noticeable effect on nausea or tremor / leg drag but none was expected day one. Tremor 90% constant , nausea not terrible but present and requiring stillness.

2/14/16 – Tremor off the hook today. Strong enough to shake the table when I rest my arms on it.

2/14/16 – Baseline: Right hand tremor constant when sitting. Right arm stiff and right foot barely comes off the ground when walking. Nausea ~75% of waking time, worst within 1-3 hours after taking Sinamet which is taken with a few crackers only and no food until at least 1 hour afterwards. Zofran sublingual tablets marginally helpful with nausea. Nausea never induces vomiting, which would be preferred, and is made worse by physical activity, sometimes even standing or sitting upright. Difficulty swallowing. Very little sense of smell. Muscles very stiff on entire right side, limiting mobility and coordination / balance greatly. Typing with left hand only. Difficulty sleeping despite fatigue due to both restless legs and an overall urge to squirm when still. Very low work capacity in the gym, but strength is still very good. Squatting is becoming difficult due to mobility and balance limitations. Depression is returning. MEDS: Lexapro 10mg daily; Amantadine 100mg 2x daily (ineffective, replacing with Pramipexole again on 2/20); Azilect 1mg daily; Sinamet (25/100mg Carbi-/Levo-dopa) 3 x daily (planned increase if needed on 2/27/16 and 3/12/16 if necessary); Lodosyn (25mg Carbidopa) with every Sinamet dose; [Daily totals: 150mg Carbidopa / 300mg Levodopa; 1 mg Azilect; 200mg Amantadine; 10mg Lexapro]. Future plans include Deep Brain Stimulation Surgery should this round of medication increases prove ineffective.