A REQUEST to those who post a question.....

[ozepook47]

As a retired, but still registered, pharmacist (who has had PD for over 8 years) in Australia, I am concerned that questions about adverse effects and medication are asked in 'isolation'. Whilst sometimes an answer can be given with the information provided, more often than not, there is a big hole of data that is missing and without which, a proper answer cannot be given. I would appeal to those who are concerned about any symptom or newly suspected adverse effect, to include ALL medication, both medically prescribed and self- prescribed, in their question. For an accurate answer, one needs to know, and I know this sounds over-the- top, the following: the patient's

1. age.

2. sex

3. weight

4. Height

5. Complete medical history including, details of operations., pathology results.

6. Complete details of medication currently taken (drug name, strength, form, dosage, date

first prescribed):

a. Medically prescribed

b. self described ( ie self purchased from pharmacy, supermarket, health food shop, on-

line etc)

7. Details of problem causing concern ( description, how long, etc)

These are the most of what a doctor or pharmacist needs to know before a proper answer can be given.. I know, it's "over the top! But in the good old days, I was registered to do Home Medication Reviews (HMR's). These were reports usually initiated by the patient,'s GP. I would go into the patients home, by appointment, get all the info above (and more), physically look at all medications in the home, check if medication was current, in-date, and, with the patien's permission, remove all medications found not to be required or out-of-date, and arrange their destruction at the pharmacy. I then analysed the data I had and reported back to the doctor. Recommendations may have been made as to whether a different or additional medication might be used and/ or dose needed changing, etc. the doctor was then free to accept or reject or modify my recommendations. Quite often it resulted in the patient being taken off some medications. The interview usually took an hour or so, and the report could take up to several hours, depending on complexity. Who paid? It cost the patient a big fat ZERO! Both the doctor and I received a fixed fee from the Federal Government under our Medicare scheme. I won't discuss any hanky-lanky that may have gone on, but I can assure you, my efforts were honest and honourable and I had many satisfied patients and doctors.

So, from a professional,s point of view, this is the correct way of making a determination about a side-effect/new symptom. Sometimes an answer can be given without these, but to answer a question about "swollen ankles" for example, a whole lot of information is needed as the cause can be one or more underlying problems.

In summary, please give at least a list of other medications and current medical problems, when posing a question. If you are still awake after reading all this, you're a champ!

Regards to you all. I will watch these blogs and questions with increased interest.

[honeycombe3]

Hi there, Thanks for the time & consideration in putting this request. Whilst I'm sure doing all the above would make answers more accurate I'm not sure that a professional or 'best' answer is what members often want. Sometimes asking about - let's say swollen ankles - is a way of making sure that one isn't alone in having those symptoms & that some others who have this condition also have PD. This opens up the universe of PD: what it is to each of us, what it isn't for some of us, what we tried that worked for us, why it worked for us not someone else ......By joining this site we can share out individual experiences in our own times & ways in the spirit of support knowing that there are no rights & wrongs & hoping that some benefit, however small, may result.

[janab]

with so many people with PD, MSA, etc. around the world I am wondering one thing, is your water fluoridated. That seems the only thing to be in common.

Are there any more pharmacist like you around here in the US?

[ozepook47]

Hi,Honeycomb3. I agree with you. This forum is to share experiences and is not suitable for the detailed analysis of the individual case. What I was trying to get across was it is really not as simple to always provide a correct answer based on the info given. As well meaning as fellow bloggers on this site may be, there is a real possibility that what appears to be a simple problem can be far more complex. What I'd like to do when I see a possible complex issue/answer, is to alert the questioner to consult their doctor or pharmacist ASAP in their own interest, and try to avoid a lengthy explanation by yours truly. Cheers!

[ozepook47]

Hi,Janab. Firstly, yes, our drinking water is fluoridated. I have not seen any credible trials suggesting fluoride ingestion may lead to PD. as for pharmacists in USA who do what I used to do, I really don't know. You might make an enquiry to your State pharmacist registration board. I assure you, I am not looking for business via this excellent forum. As I said to Honeycomb3, if I see a curly question and/ or answer, I might throw my hat into the ring in an effort to steer the person the correct way, giving a brief ( haha....what! Me brief?) explanation. But to be fair, there must be other members of this exclusive little club, out there who are pharmacists or doctors or nurses who can give their professional opinion to such questions.

What I would like to say, though, is, regardless of the extent of your PD, you should be doing some vigorous, repetitive exercise under qualified supervision. It can make one hell of a difference to your symptoms and how you feel. Google and YouTube 'rock steady boxing.. If you haven't seen it before, it's awesome! It may lead to less medication to control symptoms. But that's another story.

Cheers!

[Anemone in reply to ozepook47]

I like what you say. Keep moving. It seems to be helping me more than possible.

[Bitbit]

You are hired! Stick around

[Joanne_Joyce in reply to Bitbit]

I say amen to that. Thanks Ozepook

[honeycombe3]

Hi ozepook, Didn't mean to sound sanctimonious, maybe it's the schoolmarm in me. Your points are all valid & well taken. Following on: our springwater domestic supply is low in fluoride ...I exercise when I can but since my college days never really enjoyed it apart from swimming. I do daily Tai Chi & a regime of exercise from my physio but any 'serious' effort (eg aerobic) is beyond me at present. Such small reserves of energy as I have are used to fight pain, maintain myself, family & my house & enjoy the odd social activity. While my cognitive faculties are OK I can enjoy a reasonable standard of life motivated by friends & the many youngsters who seem to enjoy spending time here - thank heavens!

[PatV]

everyone deserves a home visit, and some intelligent attention! some don't want it. I agree, I can't fathom some of the blogs. I always want to know what kind of PD, how old, how long have you had PD . My experience may or may not be helpful. Thanks for posting!

[olpilot]

The impression I get more from this site is its like talking to people should meet in a group meeting or some other setting where you're not looking for actual medical advice but you just talk to you about what things you're doing to you how you're feeling. And the most people know where to get some advice real advice you go to your doctor if needed. I don't think you will ever see 2pwp together who don't talk about meds, side effects Parkinson's, or their grandchildren.

Take care all

[soup]

I understand the need to discuss worries and vent feelings. I don't have Parkinson's yet cross that bridge every day.

However, to counteract all the negative blogs about meds, get can we have some positive posts too? It must be very disheartening for newly diagnosed to get just one side of any story either good or bad.

I think ozepook47 has made a good point, that everybody is different and while we accept this about Parkinson's, the unwanted side effect, of Pd meds are also individual. It is good to know that you are not the only one, but could we hear from people who are not experiencing difficulties which make using the drugs impossible for them?

My Husband has had very few side effects from either his Requip XL, Sinemet or Resageline. And, while there is plenty of time for all of that to develop we are just enjoying the freedom his PD drugs regime has given us.