Chapter 265 - A Small Change Perhaps
She was fortunate to make an appointment to see our usual GP last Thursday, usually he is away during school holidays and when he is there one often needs to wait a week for a vacancy. Her need to see him was simply to renew some of her scripts, not to speak about her crippling pain, although that was discussed. He did not think her leg pains were due to thrombosis since there was no swelling, wondered about her lower back area & suggested a scan. I mentioned that the neuro wanted that done but he, the GP, had thought to do so at the time was too close to another scan she had done. Anyway, he referred her for a scan, wondering whether she will be able to remain still long enough. I wondered whether she will even be able to get on & off the trolley! Some time ago I decided that we will always be prepared with a typed list of her meds whenever she sees a doctor; the confusion that results when she attempts to detail her meds while the doctor attempts to take notes provides ample opportunity for errors in prescribing & understanding. So I irritated her that morning by pedantically recording her meds; she had returned to a 4-hourly regime, was taking Deralin in 40mg doses again about which I reminded her that at the neuro's suggestion she had reduced that and in consequence had neither falls or "mini" blackouts so why the hell return to 40mg? Due to the "shakes" of course; anyway, she has now returned to 20mg of Deralin. The GP, in typing his notes, queried the Cenovis, bought over-the-counter after magnesium was recommended some months ago by another doctor when she was unable to see him, the usual one. Magnesium had been prescribed because at the time she had been describing her leg pains as "cramps" and magnesium (in the form of Cenovis) may alleviate the pain. The GP said that the Vitamin B6 component of Cenovis may diminish the effectiveness of her PD meds. However, for some years she has taken Vitamin B6 on the published advice in the book "Stop Parkin' and Start Livin'" by Coleman (page 133), although she stopped taking individual B6 tablets when she began taking Cenovis about a year ago.
A quote from http://www.mayoclinic.com/health/vitamin-b6/NS_patient-b6/DSECTION=safety says, in reference to Vitamin B6
Use cautiously in patients taking agents for Parkinson's disease, as pyridoxine enhances the metabolism of levodopa, reducing its antiparkinsonism effects. However, the use of carbidopa and levodopa (Sinemet®) may avoid this interaction, as carbidopa can reduce pyridoxine levels.
I will discourage her from taking either Cenovis or B6. Perhaps there is another form of magnesium available, although the pain she has been experiencing recently surely could not be worse with or without magnesium. The following image shows her meds, with the Cenovis scribbled out by the GP.
In the middle of the above verbiage she called for urgent help, the Metamucil I add every few days to her evening glass of fruit juice was having an impact on her; fortunately I found her in her sewing room in her wheel chair so it was only a matter of pushing her to the bathroom without pain when walking behind her trolley. Earlier the library book in her 7" tablet had timed out when she needed to sit for awhile until she was ON, then later she cornered herself in the sewing room.
On Friday the kids wished to meet with us for her birthday, but they wanted to meet somewhere else than the usual convenient places, such as our town or one half way between. So we met in another little town, with a handful of tourist traps & restaurants. Not a good choice for someone with painful walking problems made worse by uneven terrain, so I had to push her in her collapsible walker, which doubles as a wheel chair, over bumps, over gutters, steps and most shops we did not enter because of the confined cluttered spaces. Where we had lunch provided easy access if the 45 degree slope down to an access ramp was ignored. Fortunately, a quilting shop was open so she stocked up on a large number of "fat quarters" at my insistence, as a birthday present.
The painful areas in her left leg cause her to walk on her toes, almost hopping, to limit the weight on the left leg. Her steps tend no longer to be a shuffle but very small stuttering steps. She accepts the commode in the bedroom now, although at first she tolerated the painful trip to the bathroom. She continues to go at least 3 or 4 times before settling down for the night. Several mornings in this last week she has asked for the shower chair while having a shower, although she prefers not to because it restricts her ability to wash her lower regions.
A quote from http://www.mayoclinic.com/health/vitamin-b6/NS_patient-b6/DSECTION=safety says, in reference to Vitamin B6
Use cautiously in patients taking agents for Parkinson's disease, as pyridoxine enhances the metabolism of levodopa, reducing its antiparkinsonism effects. However, the use of carbidopa and levodopa (Sinemet®) may avoid this interaction, as carbidopa can reduce pyridoxine levels.
I will discourage her from taking either Cenovis or B6. Perhaps there is another form of magnesium available, although the pain she has been experiencing recently surely could not be worse with or without magnesium. The following image shows her meds, with the Cenovis scribbled out by the GP.
In the middle of the above verbiage she called for urgent help, the Metamucil I add every few days to her evening glass of fruit juice was having an impact on her; fortunately I found her in her sewing room in her wheel chair so it was only a matter of pushing her to the bathroom without pain when walking behind her trolley. Earlier the library book in her 7" tablet had timed out when she needed to sit for awhile until she was ON, then later she cornered herself in the sewing room.
On Friday the kids wished to meet with us for her birthday, but they wanted to meet somewhere else than the usual convenient places, such as our town or one half way between. So we met in another little town, with a handful of tourist traps & restaurants. Not a good choice for someone with painful walking problems made worse by uneven terrain, so I had to push her in her collapsible walker, which doubles as a wheel chair, over bumps, over gutters, steps and most shops we did not enter because of the confined cluttered spaces. Where we had lunch provided easy access if the 45 degree slope down to an access ramp was ignored. Fortunately, a quilting shop was open so she stocked up on a large number of "fat quarters" at my insistence, as a birthday present.
The painful areas in her left leg cause her to walk on her toes, almost hopping, to limit the weight on the left leg. Her steps tend no longer to be a shuffle but very small stuttering steps. She accepts the commode in the bedroom now, although at first she tolerated the painful trip to the bathroom. She continues to go at least 3 or 4 times before settling down for the night. Several mornings in this last week she has asked for the shower chair while having a shower, although she prefers not to because it restricts her ability to wash her lower regions.
posted by Kilpike | 12:49 pm
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