Saturday, October 30, 2010

fluctuation of blood pressure

The pressure with which the blood flows in the body is known as blood pressure. Normal adult blood pressure should be 120/80 mmHg. But it fluctuates many times in a day. The lowest blood pressure can be measured when we are sleeping or in a relaxed state, but if the blood pressure goes below 90/60 mmHg then this condition can be considered as low blood pressure. Low blood pressure is also known as hypotension. There are several side effects of low blood pressure. If not taken care of on time, it may take you to dangerous consequences.

Depending upon the causes and the condition of the individuals body the side effects of low blood pressure can be mild or dangerous. Some of the causes of low blood pressure are dehydration, severe bleeding due to injury, inflammation of any organ, heart diseases, heart blockage, low pulse rate, pregnancy, etc. It may also be caused due to the drug toxicity or due to the side effects of some medication. Age can also be a factor responsible for low blood pressure. It is very important to keep an eye on these causes so as to understand the risk factor of low blood pressure.

Low Blood Pressure: Side Effects

If the blood pressure is low, the organ will not be able to get enough oxygen. This may result in many complications and life threatening consequences. Hence it becomes very important to understand the side effects of low blood pressure. Following are some of them.

Nausea
This is one of the most common signs of low pressure. As the blood flow slows down in low blood pressure, there is a deficiency of blood and oxygen in the brain. This usually results in nausea. It can be caused due to the gastrointestinal distress.

Dizziness
Low blood pressure can result in dizziness and lightheadedness. Sudden change in the posture like immediately getting up from the bed after sleeping can also cause dizziness. This condition is also known as hypotension. It is mostly seen in people above the age of 60. It can also be a result of severe dehydration.

Fainting
Low blood pressure is considered as the most common cause for fainting. Insufficient amount of blood flow and scarcity of oxygen causes fainting. Due to this the people are at a greater risk of getting injured, as they can faint whenever their blood pressure drops drastically.

Effects on Heart
As the blood flow becomes slow and there is not enough pressure for the heart to pump blood to different parts of the body, it may result in many heart diseases. It may even result in heart attacks.

Effects on Brain
Due to the low blood pressure the brain is unable to get proper blood and oxygen. This may affect the nervous system and may result in confusion, metal illness, strokes, nerve damage etc. It may also affect the functioning of other parts of the body as every part of the body receives command from the brain.

Effects on Kidney
The work of a kidney is to eliminate the toxins from our body. But low blood pressure can hinder its work and may result in toxin build up in the kidney. This may even damage the kidney and increase the toxicity in the blood.

Now that you know about various side effects of low blood pressure you may need to go for a proper check up to find out the cause behind it. If the cause behind it is diagnosed, then treatment for low blood pressure will be easy but should be immediately. As it may take a life threatening turn, you should not ignore it at all.
By Niharika Arya
Published: 10/1/2010

Blood pressure

The pressure with which the blood flows in the body is known as blood pressure. Normal adult blood pressure should be 120/80 mmHg. But it fluctuates many times in a day. The lowest blood pressure can be measured when we are sleeping or in a relaxed state, but if the blood pressure goes below 90/60 mmHg then this condition can be considered as low blood pressure. Low blood pressure is also known as hypotension. There are several side effects of low blood pressure. If not taken care of on time, it may take you to dangerous consequences.

Depending upon the causes and the condition of the individuals body the side effects of low blood pressure can be mild or dangerous. Some of the causes of low blood pressure are dehydration, severe bleeding due to injury, inflammation of any organ, heart diseases, heart blockage, low pulse rate, pregnancy, etc. It may also be caused due to the drug toxicity or due to the side effects of some medication. Age can also be a factor responsible for low blood pressure. It is very important to keep an eye on these causes so as to understand the risk factor of low blood pressure.

Low Blood Pressure: Side Effects

If the blood pressure is low, the organ will not be able to get enough oxygen. This may result in many complications and life threatening consequences. Hence it becomes very important to understand the side effects of low blood pressure. Following are some of them.

Nausea
This is one of the most common signs of low pressure. As the blood flow slows down in low blood pressure, there is a deficiency of blood and oxygen in the brain. This usually results in nausea. It can be caused due to the gastrointestinal distress.

Dizziness
Low blood pressure can result in dizziness and lightheadedness. Sudden change in the posture like immediately getting up from the bed after sleeping can also cause dizziness. This condition is also known as hypotension. It is mostly seen in people above the age of 60. It can also be a result of severe dehydration.

Fainting
Low blood pressure is considered as the most common cause for fainting. Insufficient amount of blood flow and scarcity of oxygen causes fainting. Due to this the people are at a greater risk of getting injured, as they can faint whenever their blood pressure drops drastically.

Effects on Heart
As the blood flow becomes slow and there is not enough pressure for the heart to pump blood to different parts of the body, it may result in many heart diseases. It may even result in heart attacks.

Effects on Brain
Due to the low blood pressure the brain is unable to get proper blood and oxygen. This may affect the nervous system and may result in confusion, metal illness, strokes, nerve damage etc. It may also affect the functioning of other parts of the body as every part of the body receives command from the brain.

Effects on Kidney
The work of a kidney is to eliminate the toxins from our body. But low blood pressure can hinder its work and may result in toxin build up in the kidney. This may even damage the kidney and increase the toxicity in the blood.

Now that you know about various side effects of low blood pressure you may need to go for a proper check up to find out the cause behind it. If the cause behind it is diagnosed, then treatment for low blood pressure will be easy but should be immediately. As it may take a life threatening turn, you should not ignore it at all.
By Niharika Arya
Published: 10/1/2010

Wednesday, October 27, 2010

PLM reader

I really liked your positive attitude about the importance of exercise in fighting PD and in keeping mobility.

Before PD I was a fitness instructor-- now, I've had to take a break and reassess my own exercise plan but I could use some help and encouragement... Maybe we can find a way to keep each other motivated.

I created a forum on an exercise and fitness website called, "Living With a Chronic Illness-- Yet Keeping Fit!" recently and would really like to see you join and post specifics on your exercise plans and struggles to keep fit. TOGETHER we can fight this disease and exercise is the one thing to show we are still in control.

Please take a moment to look at the forum and feel free to join and start submitting to discussion!!

Here's the link to forum:

http://www.realsolutionsmag.com/idealbb/forum.asp?forumID=107



Posted Apr 24, 2008 03:22PM

Monday, October 25, 2010

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Personal Stories.Secret recipe behind the mask

Hero Teo
Kuala Lumpur, Malaysia


http://www.youtube.com/watch?v=sTpu_zBvDME

I often smiled when I watched the video recording of my kick-boxing exercise which I uploaded to You Tube. My trainers and videographer told me the same thing – “You do not look like a Parkinson’s patient at all”. Even my doctor shook his head in disbelief and said, “This is shocking. I can’t imagine a 70-year-old Parkinson’s patient doing a very strenuous exercise such as kickboxing. I am sure that you are the only Parkinson’s patient in Malaysia who is doing the kickboxing exercise.”

As early as 1998, I already had both the motor and non-motor symptoms. Since my diagnosis in 2002, I went through a period of depression, anxiety, denial and anger. Subsequently, I bounced back after discovering a secret recipe for fighting Parkinson’s, which consisted of: knowledge (is power), exercise, medications, nutrition / supplements and prayer. In my quest for knowledge, I surfed various Parkinson’s websites, raining them with questions, questions and questions. I even started the first Parkinson’s blog in Malaysia (www.heroteo.com). I tried to learn everything about Parkinson’s in order to overcome all complications - the Chinese heroes won the battles by understanding their enemy first.

Animal experiments showed that exercise may be neuroprotective. Rats which were forced to exercise had a lesser degree of brain damage after they were exposed to poison. In mice which were made to undergo treadmill exercise, there was increased production of dopamine.

Parkinson’s patients are comparable to the car. The medications are needed to help patients to start walking, while fuel or battery is needed to help start the car engine. Exercise is needed to improve the patients’ physical mobility and endurance, while driving helps to recharge the battery. Thus, exercise helps our “engines” warm up before leaving home and keep the “cars” going everyday. Even healthy people such as Bruce Lee, the Chinese Kung Fu master, know that exercise is beneficial.

As such, since 2005, I decided to “get physical”. I spend 3-4 hours everyday at the California Fitness gym, doing a wide range of “heavy” exercise such as kick-boxing, weight-training and spinning (indoor cycling). Twice a week, I do yoga exercise at home with the guidance of a trainer.

Since this year, my physical condition has drastically improved. I sleep and eat well (I eat to live, and live to eat). I enjoy driving around the Kuala Lumpur city with my wife everyday and going overseas for holiday. I managed to reduce the daily dose of Parkinson’s medications recently. Sometimes, I wonder whether I am just a “normal person” behind the mask.

I know that it is technically difficult to prove that exercise has neuroprotective effect in Parkinson’s patients. Despite this, I believe that exercise has slowed down my disease progression. I hope that my video recording will bring hope and happiness to all Parkinson’s patients in this world, by reminding them that they can still live a physically active life.



See all Personal Stories

Q & A

HI! teokimhoe, at your age of 71 yrs. it is difficult for your body to cope up with the different medications for different ailments you suffer from. You need to take up a complete evaluation of your condition from different specialists like a cardiologist, neurologist, neurosurgeon, psychiatrist and a physician. Thus you need to find a hospital or a health centre which has all the above specialist, who after examining you will evaluate your present condition and then coordinate between themselves so that they offer you a treatment which takes in to perspective the pros and cons of all the drugs to be prescribed to you. PD is a progressive disease and as the age increases the neurons and the muscle groups affecting them will be increasing in number as well as size. Doctors treating you presently are doing a good job, so it will be advisable to tell them to refer you to a hospital in Los Angeles or San Francisco, that has all the specialties mentioned above. The advantage will be that the new centre can get back to your doctors as they will need the input in your case from time to time for smooth progression of your treatment. Take care.

Comment by Dr.Kokil Mathur on Mon 25, Oct 2010 08:17am: Hi Teo Kim Hoo! Yes seizure is a side effect of Zoloft and Zydis causes twitching resembling uncontrolled movements of eyes, lips, tongue, face, arms, or legs almost mimicking seizures. So this is one possibility you will need to discuss with your doctor. Dehydration, certain medications (like the ones you are taking), heart problems, untreated diabetes, and nervous system disorders can all cause postural hypotension or fluctuation of Bp with change in position. TIAs or transient ischemic attacks can also be the cause. Certain internal ear problems can also affect blood pressure monitoring by the body by not properly signaling a change in position. Blood pressure monitoring, tilt table test (this you had), EKG, heart echo, ambulatory blood pressure recording are all required to monitor the problem. Uncontrolled shaking, dizziness and a feeling like you will pass out is usually seen with Requip. This may be the reason it was stopped. Minirin causes low sodium so this was changed to Florinef. PD may not have progressed in your case but yes a proper dose adjustment is what is probably required to control symptoms. Despite proper medications PD patients often feel spasms and twitching. Talk to your treating doctor and ask for a referral for a specialist in the US. It is difficult to suggest someone on net and it is always advisable to go through proper reference so that your case can be properly discussed between the treating doctors. Please let me know if there is any thing else and do keep me posted. Take care!

Saturday, October 23, 2010

compression stockings and hypontremia

I have been diagnosed as suffering from fluctuations in my blood pressure (BP). I have taken the Upright Tilt Test, and the results confirm that my BP fluctuates depending on the various positions I am in.Due to my upright tilt table test conclusions

Asymptomatic through passsive tilting & given S/L GT
Postural hypotension 168/81 dropped to 91/51mmHg
Negative tilt table test



As a result, I put on compression stockings to stablelize my BP.
People who have low blood pressure may also be told by their doctors that they should make use of the compression stockings typically used to deal with varicose veins. Low blood pressure can cause a pooling of blood in the veins which may or may not lead to varicose veins. Compression stockings can reduce that problem and can help keep people with low blood pressure medically safe.


My previous blood clot (T.I.A) in the year 2008 was caused by this fluctuation in my blood.
The side effects on my parkinson's medicationn were also caused by this fluctuations in my blood i.e dizziness,lightheaded,nausea ,up and down, go and off. Some people have low blood pressure all the time. They have no symptoms and their low readings are normal for them. In other people, blood pressure drops below normal because of some event or medical condition. Some people may experience symptoms of low pressure when standing up too quickly. Low blood pressure is a problem only if it causes dizziness, fainting or in extreme cases, shockcauses dizziness, fainting extreme cases, shock.

Most normal blood pressures fall in the range of 90/60 millimeters of mercury (mm Hg) to 130/80 mm Hg. But a significant drop, even as little as 20 mm Hg, can cause problems for some people.


How Is Orthostatic Hypotension Treated?
The first approach in treating orthostatic hypotension is to decrease the pooling of blood in the legs with the use of special stockings called compression stockings. These tight stockings “compress” the veins in the legs, helping to reduce swelling and increase blood flow. There now are a number of companies that make these stockings in a wide variety of sizes, and they usually can be found at stores that sell medical supplies, as well as at some pharmacies.

You should wear these stockings when you are up and about. You do not need to wear them when you are in bed. Further, it is recommend that you put the stockings on first thing in the morning while in bed and before getting up for your daily activities. It is important that you do not let the stockings bunch, gather, or roll, since this can compress the veins too much and could harm circulation. You should always watch for signs of decreased circulation, which could include discoloration of the skin, as well as pain or cramping, and numbness of the lower legs and feet.

If the stockings only provide some but not complete relief of symptoms, an abdominal binder can be used. The binder is another type of compression garment that is worn around the waist to help increase blood pressure. If these products fail to alleviate symptoms, certain drugs can be given to help increase blood volume. If you are taking these drugs, be sure to watch for signs of too much fluid in the body, such as swelling, bloating, or difficulty breathing. If these symptoms occur, call your doctor immediately




:Some suggestions for minimizing the effects include:

Standing up slowly rather than quickly, as the delay can give the blood vessels more time to constrict properly. This can help avoid incidents of syncope (fainting).
Take a deep breath and flex your abdominal muscles while rising to maintain blood and oxygen in the brain. This, however, may be contraindicated in individuals with Stage 2 hypertension. Usually medical personnel have their patients "dangle" before rising from bed to decrease the likelihood of dizziness/falling due to orthostatic hypotension. The dangling is done by having the patient sit on the side of their bed for about a minute so they do not have the sudden dizziness.
Maintaining an elevated salt intake, through sodium supplements or electrolyte-enriched drinks. A suggested value is 10 g per day; overuse can lead to hypertension and should be avoided.
Maintaining a proper fluid intake to prevent the effects of dehydration.
As eating lowers blood pressure, take your food in a larger number of smaller meals. Take extra care when standing after eating.
When orthostatic hypotension is caused by hypovolemia due to medications, the disorder may be reversed by adjusting the dosage or by discontinuing the medication.
When the condition is caused by prolonged bed rest, improvement may occur by sitting up with increasing frequency each day. In some cases, physical counterpressure such as elastic hose (stockings) or whole-body inflatable suits may be required.
Many people who experience orthostatic hypotension are able to recognise the symptoms and quickly adopt a "squat position" to avoid falling during an episode. This is because they are usually unable to co-ordinate a return to sitting in a chair, once the episode has commenced.
Avoiding bodily positions that impede blood flow, such as sitting with knees up to chest or crossing legs.
[edit] Prognosis





--------------------------------------------------------------------------------

Monday, October 18, 2010

My story with hypontremia

A wrongly prescription Minirin for hypontremia by doctor resulted my sodium at low level and have to stay for five day in the hospital I was released from hospital until my sodium level to normal level 135.

In the hospital I was inserted with sudium into my body days and night for five days and slept with sleeping pills.
.
The side effects of Minirin are vomitting, dizziness and short of breath and lowering down your normal sodium level

As the result I was instructed to stop taking requip and jumax except Sinemet regular.

Hyponatremia is the result of insufficient sodium in the body fluid that surrounds cells. Proper sodium levels are important in maintaining blood pressure and in keeping nerves and muscles functioning properly. The condition of having insufficient or low levels of sodium is called hyponatremia.
.

Common symptoms of hyponatremia include fatigue, irritability, headache, and water retention, loss of appetite, and nausea or vomiting. Other signs or symptoms of hyponatremia are mental in nature and include abnormal or confused mental status, hallucination, and possibly unconsciousness. Often times abnormal presence of mind and confusion are the first serious symptoms of hyponatremia as the brain cells cannot accommodate swelling due to the water retention that accompanies hyponatremia.

Hyponatremia is diagnosed through serum and urine testing. There is generally always an underlying cause of hyponatremia, which must also be diagnosed and treated. Insufficient sodium levels can be treated with intravenous fluids, restricted diet, and supplemental oxygen. Medications that offset some of the symptoms of hyponatremia can also be administered to restore comfort and prevent seizures.

Causes of hyponatremia include burns, dehydration due to excessive vomiting or diarrhea, congestive heart failure, as a side effect of diuretics, kidney disease and certain other diseases. Acute hyponatremia, such as a sudden reduction in sodium levels over a 24 to 48 hour period due to extreme physical exertion or dehydration, is considered more dangerous than chronic hyponatremia that can occur with certain diseases or disorders.

Praise Lord I started again my requip and Jumax without problems as they are essential to stable my foot on floor without freeze,

I am glad to start again going to gym to attend my exercises program.

Teo's experience is one we should all be aware of. He is describing one of a dozen electrolyte problems that can catch us by surprise. Not only sodium but also minerals like potassium, calcium, and magnesium - all are absolute requirements for nerves and muscles to function. The symptoms merge seamlessly with those of PD and the causes can range from medication problems to simple polyuria. In fact, if you have to pee much in the night you should not only think in terms of water loss but also mineral. Ditto if you exercise a lot. The effects can be dramatic but are easily written off as PD.

Thanks for sharing. I hope you have fully recovered and are up and running.


Kind regards/Lawrence

Hi Mr Teo,


Hope everything is well with you now. :)




Take care.
Chai HowEDear Doctor I have been diagnosed as suffering from fluctuations in my blood pressure (BP). I have taken the Upright Tilt Test, and the results confirm that my BP fluctuates depending on the various positions I am in. As a result, my physician has prescribed Minirin to me to stablelize my BP.Recently, owing to my stress due to personal issues and also the effect of Minirin, my BP shot up to 210/50. I vomitted and felt dizzy, and was subsequently hospitalized for observations. During my stay at the hospital, I also fell. It was discovered that the sodium level in my blood was very low. That apparently led to my dizziness and possibly blackout, which in turn led to my fall. I was given sodium solution through intravenous injection to increase my blood sodium level. I was subsequently discharged.Subsequent to my discharge, my physician changed the dosage of my medication for both Parkinson’s Disease (PD) and also the medication to maintain my BP. Minirin was substituted with Florinef. As far as PD is concerned, prior to my hospitalization, my daily dosage was Requip (6 mg), Sinemet 25/100 (6 tablets) and Jumax (50 mg). Both Requip and Jumax was stopped. I was asked by my physician to only take Sinemet 25/100 (6 tablets) daily to contain the progression of PD.I subsequently experienced mild seizures, whereby I cannot move my hands and legs for perhaps a time span of 5 to 10 minutes. I would be frozen, so as to speak. This seizure episodes would take place nearly once everyday. It must be stressed that I didn’t suffer from any seizure prior to the change in the dosage of my medication. My worries are as follows :- (a) Is it normal for patients suffering from PD to have episodes of seizures? Are these seizures a sign that my PD has advanced in progression? (b) Is it correct for my physician to reduce the dosages of my PD medication so significantly? And does such a reduction result in my seizure, or perhaps an advance in the progression of PD? (c) What are the causes of such seizures? For your information, I am also under treatment for Bipolar Syndrome, and I am on medication of Zoloft and Zydis. Does this medication also contribute to seizures, as a side effect? I shall be very grateful if you could revert to me on the above. I am also considering coming over to the US for continued treatment of PD and possibly Bipolar Syndrome. I shall be very grateful if you could refer some of the good physicians for consultation, preferably in Los Angeles or San Francisco. Best regards Teo Kim Hoo

PLM Post Yoga

incredible! Teo, I just watched your Yoga Youtube video. How incredible! Thank you so much for the motivation. The half moon, tabletop and scale postures are really challenging. You give me hope. I added that clip to my favorites
Doing facial therapy helpful to relief facial masked.

Is it helpful for slurred speech?

Is relief the facial muscle helpful people with slurred speech?

Kindly advise


TEOKIMHOE

to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families

Dr. Mahler

Advanced Member

Group:
Speech Clinician Moderators Posts:
13 Joined:
02-April 07 Posted Yesterday, 02:28 PM

There is no evidence that facial therapy helps slurred speech. That is because the movements for facial therapy are very different from those required for speech movement. If a person with PD wants to improve their understandability, then they need to engage in intensive voice and speech exercise. As one example, there is a lot of literature supporting LSVT LOUD, an intensive voice treatment that incroporates some of the principles of neural plasticity.

Communication is very important for quality of life. I recommend anyone who is wanting to learn more about therapy to help slurred speech get a prescription from their doctor for an evaluation by a speech-language pathologist familiar wtih treatment of people with PD. The neuroscience literature supports early intervention before it is hard to understand the person.

Friday, October 8, 2010

My experience with Minirin 2

I had negative upright table test in Raffles Hospital Singapore


My doctor prescribes me Minirin to increase my low blood pressure

I vomitted by taking Mirnirn on the five day. I had dizzinness, tiredness and low blood pressure too.

My doctor instructed me to do MRI brain screening and heart XR again with anticipation of a second stroke as I had once T.I.A in 2008.
I have to stop taking Requip and Jumax dosages.

I have been with these medication more than 5 years.

As the result I have duminess leg and could not stable on standing up.
My sodium had gone down to 120 level.
.
I had to stay in the hospital to receive my first times compond sudium lactate Intravenous B.P Three bottles daily to increase my sodium level to normal.

Minirin
Minirin works by increasing the amount of water that is reabsorbed by your kidneys.
When it is given in higher doses, it can also raise your blood pressure.

Because the medication is causing your kidneys to reabsorb water, this can lead to your sodium levels to drop.
If your sodium levels drop too much, this can make you very ill. At sodium levels of 120, you can feel nauseated, more short of breath, dizzy, fatigued and be vomiting.

So, much of your symptoms were likely due to your low sodium, which was

There are many potential reasons for orthostasis or dizziness on standing up. Dopamine agonists and TCA antidepressants can have this as a side effect. Alternatively it could be an issue of hydration and you may need 6-8 glasses of water a day and compression stockings. Occassionally drugs like midodrine, florinef and mestinon are needed to keep the BP up._________________Michael S. Okun, M.D.
Back to top

Bipolar,disorder

Dear Dr.Okun,

I have bipolar disorder resulted I have up and down blood level.

My doctor advises me to consult Psychiatrist.

I have to stop taking my PD medication Jumax and Requip;

My upright Tilt table test is 168/81 mkmHg dropped to 91/51 mmHg.

Regards

TEOKIMHOE

to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families
0

My experience with Minirin

I have been diagnosed as suffering from fluctuations in my blood pressure (BP). I have taken the Upright Tilt Test, and the results confirm that my BP fluctuates depending on the various positions I am in. As a result, my physician has prescribed Minirin to me to stablelize my BP.

Recently, owing to my stress due to personal issues and also the effect of Minirin, my BP shot up to 210/50. I vomitted and felt dizzy, and was subsequently hospitalized for observations. During my stay at the hospital, I also fell. It was discovered that the sodium level in my blood was very low. That apparently led to my dizziness and possibly blackout, which in turn led to my fall. I was given sodium solution through intravenous injection to increase my blood sodium level. I was subsequently discharged.

Subsequent to my discharge, my physician changed the dosage of my medication for both Parkinson’s Disease (PD) and also the medication to maintain my BP. Minirin was substituted with Florinef. As far as PD is concerned, prior to my hospitalization, my daily dosage was Requip (6 mg), Sinemet 25/100 (6 tablets) and Jumax (50 mg). Both Requip and Jumax was stopped. I was asked by my physician to only take Sinemet 25/100 (6 tablets) daily to contain the progression of PD.

I subsequently experienced mild seizures, whereby I cannot move my hands and legs for perhaps a time span of 5 to 10 minutes. I would be frozen, so as to speak. This seizure episodes would take place nearly once everyday. It must be stressed that I didn’t suffer from any seizure prior to the change in the dosage of my medication.

My worries are as follows :-

(a) Is it normal for patients suffering from PD to have episodes of seizures? Are these seizures a sign that my PD has advanced in progression?
( Is it correct for my physician to reduce the dosages of my PD medication so significantly? And does such a reduction result in my seizure, or perhaps an advance in the progression of PD?
© What are the causes of such seizures?

For your information, I am also under treatment for Bipolar Syndrome, and I am on medication of Zoloft and Zydis. Does this medication also contribute to seizures, as a side effect?

I shall be very grateful if you could revert to me on the above.

I am also considering coming over to the US for continued treatment of PD and possibly Bipolar Syndrome. I shall be very grateful if you could refer some of the good physicians for consultation, preferably in Los Angeles or San Francisco.

Best regards

Teo Kim Hoo

to help the PD patients aware the diseases and encourage to set up support groups to educate the patients and their immediate families

I have answered most of these already in your previous posts, so I would ask that you look back through those posts.

There is a NPF center of excellence at UCSF in San Fran and one at USC in LA.

Good luck.

wrongly prescription Minirin

Wrongly prescription minirin
Posted on October 8th, 2010 by heroteo
I have been diagnosed as suffering from fluctuations in my blood pressure (BP). I have done the Upright Tilt Table Test and the results confirmed fluctuations in my BP on various positions. My physician prescribed me Minirin to stablelize my BP. Due to my stress from personal issues and also the effect of Minirin, I discovered one day that my BP had increased to 210/50. I started vomitting and I was thereafter hospitalized for observation. It was there they discovered that the sodium level in my blood is low, and that further led to me falling. I was eventually discharged.

Upon discharged, my physician decreased my intake of Parkinson’s daily medication from Requip (6 mg), Sinemet 25/100 (6 tablets) and Jumex (10mg) to only Sinemet 25/100 (6 Tablets). Requip and Jumex has been stopped. He had also substituted Minirin to Florinef to stablelize my BP level.

Lately I have experienced mild seizures in the sense that I temporarily cannot move my legs and limbs for approximately 5 - 10 minutes duration. This has happened nearly once everyday. This could very well be due to an immediate decrease in my BP when I stand up.

However, my worries are as follows :-

(a) Whether seizures are common amongst patients suffering from PD. If yes, is it a sign of advancement of PD progression?
( What is the exact cause for such seizures to occur?
© Has my PD medication been decreased too significantly? For your information, I have never experienced seizures before the change in medication dosages.

For your further information, I am also on medication for Bipolar Syndrome, namely, Zydis 5 mg daily, Zoloft 50 mg. Does these medication also result in side effects?

I would be grateful for your input.

Best regards
Teo Kim Hoo

Teo, I will post for you. Seizures is not common in PD and seizures have a different etiology than PD

PLM reader

I subscribe to your page because you seem to have the energy and the will to fight PD and I would like to be like you. I am trying to fight as you do!

Posted Oct 20, 2009 10:29PM

Wednesday, October 6, 2010

Minirin

Minirin works by increasing the amount of water that is reabsorbed by your kidneys.
When it is given in higher doses, it can also raise your blood pressure.

Because the medication is causing your kidneys to reabsorb water, this can lead to your sodium levels to drop.
If your sodium levels drop too much, this can make you very ill. At sodium levels of 120, you can feel nauseated, more short of breath, dizzy, fatigued and be vomiting.

So, much of your symptoms were likely due to your low sodium, which was due to the minirin.
Medical
Ask a Medical Question, Get an Answer AS

why Minirin caused side effects vomiting,short of heart breath,tired and sodium at abnormal level at 120

Your Expert needs more information
From Dr. Abby
Tuesday, October 05, 2010 6:52 PM EST

Hello,

First, why were you on the medication?

to increase my low blood level as there are at negative level upright and sit down. short of breath, tir

Expert

You have received an Answer!
From Dr. Abby
Tuesday, October 05, 2010 7:13 PM EST

Ok, thank you for clarifying,

Minirin works by increasing the amount of water that is reabsorbed by your kidneys.
When it is given in higher doses, it can also raise your blood pressure.

Because the medication is causing your kidneys to reabsorb water, this can lead to your sodium levels to drop.
If your sodium levels drop too much, this can make you very ill. At sodium levels of 120, you can feel nauseated, more short of breath, dizzy, fatigued and be vomiting.

So, much of your symptoms were likely due to your low sodium, which was due to the minirin.

Feel free to ask any follow up questions,

Dr Abby

Monday, October 4, 2010

defination of cure of PD

The word “cure” is often used as the stated, or assumed, ultimate goal of Parkinson’s disease research. The more I think about it, the less sure I am just what constitutes a “cure” in connection to PD. A big part of the difficulty of coming up with a definition may be because it’s tough to separate effects of the disease itself, medications and the simple process of aging.

So …. can you offer a working definition of what a “cure” is in relation to PD?

Great question.

A cure is usually when the disease has been completely eradicated from an individual patient.

Symptomatic therapy is when a therapy helps improve individual symptoms.

Disease modification is when a therapy improves the course or slows the course of the disease.

Hope that helps.

Michael S. Okun, M.D.

new drug for hypotension

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19-January 07 LocationUniversity of Florida Posted Today, 01:08 PM

Dear forum members,

Forty percent or more of PD patients suffer from orthostatic hypotension (dizziness when standing, passing out, etc.). Dr. Lowe from the Mayo clinic presented some very promising results at the World Congress for PD in Scotland last week.

There is a drug called droxidopa in trials; which is a hydroxylated form of levodopa.

Though this may be above some heads I want to mention the two mechanisms of action:

1- post-ganglionic alpha 1 receptor is stimulated on aterioles
2- there seems to be repletion of adrenergic terminals with the neurochemical norepinephrine in both the peripheral nervous system and the central nervous system

The preliminary data is yet to be released but what was presented was very promising.

Midodrine which is another drug available to treat this condition has a greater effect on the blood pressure when lying down. Droxidopa has a greater effect when standing which is potentially more clinically important to patients.

The droxidopa seems to be well tolerated.

We await to hear about the 20-25% of patients who were excluded from the studies because the drug didn't seem to be effective enough in the dose titration part of the study,

We will keep you posted as more data becomes available.

Michael S. Okun, M.D.

parkinson and blood pressure

Posted: Fri Apr 18, 2008 6:13 am Post subject: Parkinson’s medication and Blood pressure

Dear Doctor, I am taking Lavodopa,Carbidopa and dopamin agonist for two year Close monitoring is required for people with certain medical condition. After I have a minor stroke (T.I.A) recently, I experience two different blood pressure i.e. decreased blood pressure when rising from a seated position or lie-down on bed after lengths of times. I feel dizziness on standing,headache or fainting My mouth run dry and thirsty Insomnia, anxiey, and fatigue, malaise Kindly elaborate Thanks TEOKIMHOE
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Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Sun Apr 20, 2008 7:05 pm Post subject:

There are many potential reasons for orthostasis or dizziness on standing up. Dopamine agonists and TCA antidepressants can have this as a side effect. Alternatively it could be an issue of hydration and you may need 6-8 glasses of water a day and compression stockings. Occassionally drugs like midodrine, florinef and mestinon are needed to keep the BP up._________________Michael S. Okun, M.D.
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Anonymous
Posted: Sun Apr 20, 2008 9:47 pm Post subject:

Normal blood pressure is regulated by specific reflexes in the nervous system. Parkinson’s disease can impair this reflex mechanism and result in lowered blood pressure.Low blood pressure usually presents itself as side-effect of anti parkinson’s medications. Levodopa-carbidopa, dopamine agonists and other antidepressions and sleeping medications may potentiate a hypotensive event Source: Linda P.Miller,R.N.Med Posted by Hero Teo at 10
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Anonymous
Posted: Sat Apr 26, 2008 2:16 am Post subject: dizzinness and parkinson’s medication

I am glad that your dizziness has subsided. Dizziness is a very common symptom among Parkinson’s patients. It needs extensive work-up, e.g. blood pressure, heart rhythm, blood tests (diabetes) and even brain scan. A common cause of dizziness among Parkinson’s patients is the medications for PD, which can lower the blood pressure. Commonly, I use fludrocortisone to elevate the blood pressure. Parkinson’s patients need regular blood pressure monitoring (lying position and standing). Dr Chew Nee Kong, Kuala Lumpur.
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Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Sun Apr 27, 2008 8:48 am Post subject:

Thanks for the nice comment._________________Michael S. Okun, M.D.

As dopamine agonists Ropinirole (Requip) can have this as a side effect (dizzinness at all time) I stop taking them i.e 6 mg Requip daily. I substitute Lavodopa 25/100 Sinemet 2 1/2 dosages with 2 dosage Jumax 5mg daily immediately.

florinef

Dear Doctor, I am taking Lavodopa,Carbidopa and dopamin agonist for two year Close monitoring is required for people with certain medical condition. After I have a minor stroke (T.I.A) recently, I experience two different blood pressure i.e. decreased blood pressure when rising from a seated position or lie-down on bed after lengths of times. I feel dizziness on standing,headache or fainting My mouth run dry and thirsty Insomnia, anxiey, and fatigue, malaise Kindly elaborate Thanks TEOKIMHOE
Back to top


Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Sun Apr 20, 2008 7:05 pm Post subject:

There are many potential reasons for orthostasis or dizziness on standing up. Dopamine agonists and TCA antidepressants can have this as a side effect. Alternatively it could be an issue of hydration and you may need 6-8 glasses of water a day and compression stockings. Occassionally drugs like midodrine, florinef and mestinon are needed to keep the BP up._________________Michael S. Okun, M.D.
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Anonymous
Posted: Sun Apr 20, 2008 9:47 pm Post subject:

Normal blood pressure is regulated by specific reflexes in the nervous system. Parkinson's disease can impair this reflex mechanism and result in lowered blood pressure.Low blood pressure usually presents itself as side-effect of anti parkinson's medications. Levodopa-carbidopa, dopamine agonists and other antidepressions and sleeping medications may potentiate a hypotensive event Source: Linda P.Miller,R.N.Med Posted by Hero Teo at 10
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Anonymous
Posted: Sat Apr 26, 2008 2:16 am Post subject: dizzinness and parkinson's medication

I am glad that your dizziness has subsided. Dizziness is a very common symptom among Parkinson's patients. It needs extensive work-up, e.g. blood pressure, heart rhythm, blood tests (diabetes) and even brain scan. A common cause of dizziness among Parkinson's patients is the medications for PD, which can lower the blood pressure. Commonly, I use fludrocortisone to elevate the blood pressure. Parkinson's patients need regular blood pressure monitoring (lying position and standing). Dr Chew Nee Kong, Kuala Lumpur.
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Dr. OkunJoined: 19 Jan 2007Posts: 251Location: University of Florida
Posted: Sun Apr 27, 2008 8:48 am Post subject:

Thanks for the nice comment._________________Michael S. Okun, M.D. 4/28/08 by teo Delete

Born Parkinson's

I have heard of Parkinson’s Disease. I don’t understand how you get it. I was told you are born with it. Is this true and how do you know if you have it or not?
(anonymous)

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A:

At this time, we really don’t know if one is “born” with Parkinson’s disease
or becomes affected with it as he grows older. One theory suggests that some people are born with fewer dopamine-producing cells (either genetically
or that there is some problem during pregnancy - such as trauma or a virus -
which contributes to being born with fewer dopamine-producing cells). Then,
as the individual ages and naturally loses cells, this person would pass
the 80% dopaminergic neuronal loss that is needed before PD symptoms appear. Other theories suggest some sort of environmental insult causing the drop in
dopamine cells. Unfortunately, we just don’t know yet as these are theories
that must either be proven or disproven via research.

How do you know you have Parkinson’s disease? The best way is to consult a
neurologist who specializes in movement disorders. Neurology, while a
specialty itself, is split into sub-specialties. Parkinson’s disease is a
movement disorder so one who has additional training in movement
disorders, and thus sees primarily patients with such movement disorders, is the best type of physician to consult for a diagnosis.

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