Azilect and Anesthesia and Colonoscopies:

[Motal]

I have dropped more than 40 lbs - almost 25% of what I had weighed when my PD motor symptoms started up three years ago. It just happened. I wasn't trying to downsize. At first, not having bingo arms seemed like a Parkie perk - but the loss of the last 10 pounds in recent months has me and some around me concerned.

The culprit could well be that I avoid eating significant proteins during the day because they interfere so much w my levodopa uptake. My GP wanted to be sure it wasn't anything else so she referred me to a specialist for a colonoscopy., which I was more or less due for anyway. The gastroenterologist ’s office was all set to schedule one ...

...until I mentioned I took Azilect and explained that MAOI’S didn’t mix well with a bunch of anesthesia drugs. I guess they consulted a PDR cos they did not schedule a colonoscopy for me. I didn't think to ask at the time but I have since learned that just because you're getting anesthesia doesn't necessarily mean there's an anesthesiology specialist - doc, nurse - on hand to take care of you if things go south and complications arise during your procedure.

Options now are to have a colonoscopy done at the hospital - where there is an anesthesiologist on staff - or have it done at a gastroenterology clinic without benefit of anesthesia. Thing about that second option is I’m told that the patient - sorry about this visual - may have to move around the scope. With left side rigidity I'm wondering if I'm capable of working with the team on that.

Trying to sort thru this. What’s your experience been - with Azilect, elective procedures and anesthesia?



PS: I called the National Parkinson's foundation hot line and they confirmed the MAOI-B interaction with anesthetic drugs. They sent me wallet-ready medic-alert cards that spell all that out.]

[Oceanwind]

Hi Motal,

Sorry to hear of your woes! I too have lost weight, and mostly in my face and chest area. (Not exactly what one hopes for when one has plenty of other not-so-attractive fatty areas that could use some reduction!)

I am a little worried as well, although, unlike your 45 pounds, my weight loss is only 15 pounds since diagnosis a few years ago. I believe it's due to my slow eating which results from an inefficient tongue/swallowing system. It's sometimes hard work chewing and swallowing, but I refuse to go on a diet of pablum/soup/ENSURE until I absolutely can't chew anymore, or until I start having choking fits!

Perhaps my weight loss (maybe yours too) could be because of gastro issues. What I notice is that I don't feel as hungry, and the usual signals that tell my brain that I should eat are not there anymore. Starting with not having the right kind of saliva, or not enough of it to start digesting my food, and then following, the typical Parkinson's problems of motility/constipation. I had a diagnosis of ulcerative colitis at 15, and although no flare ups since I was 25, I'm partly wondering if whatever went wrong back then in my colon caused me to be diagnosed with Parkinson's many years later.

I am not taking azilect, so don't have the same problem that you have with anesthesia in your colonoscopy. Like we don't have enough challenges, eh?

Wishing you luck with getting a solution that works for you.

[Motal in reply to Oceanwind]

Thanks. OW. Hope things work out for you, too...

[Sane1]

I have been on Azilect 1mg/day since diagnosed almost 4 years ago. Had an outpatient procedure done under anesthesia for kidney stones last Fall. I did mention my concerns to the anethesia staff prior to procedure. I had absolutely no problems with the procedure.

[Sane1 in reply to Sane1]

You might find this informative.

parkinsonsprogress.org/2014...

[Motal in reply to Sane1]

Thanks. Interesting read.

[DianeF]

Interestingly enough, I've gained weight since my Parkinson's diagnosis and since beginning medications(Azilect, Sinemet, Amadatine). I believe my Parkinson's was initially induced/exacerbated by Anesthesia and the anti-nausea medication they gave me post knee replacement surgery. My neurologist tells me it is not unusual for people with Parkinson's to have difficulty with general anesthesia post-surgery but that having a colonoscopy while on Azilect is fine as it is a lighter, twilight anesthesia.

[Mike1942]

I am new to this forum, but I have previously posted elswere about a possible link between an aortic valve replacement and later diagnosis of PD. Prior to the heart operation I had some minor indications that " something was wrong" my writing had got smaller and some minor hand trembling was evident. I had a bad reaction to the anesthetic and PD followed within 12 months.

[ognjen]

I am in process of preparation for surgical procedure (hernia) .. As I understand Azilect is problem for anesthesia?

[Sedona]

My blood pressure dropped dangerously low during colonoscopy and had to be brought out from under anesthesia.