As part of my assessment for Deep Brain Stimulation (DBS) surgery my doctors instructed me to present myself at Auckland Hospital one morning UNMEDICATED!! They call this the LEVODOPA Challenge.
Having been taking sinamet (levadopa) continuously for five years I was more than a little worried.
I am fortunate enough at this stage to wake up with what we call "sleep benefit"*, so I managed to slowly get dressed and catch a cab to Auckland hospital. However by the time I met with Lorraine (Movement Disorder Nurse) I was basically moving like a slow-motion replay of a snail race.
Unlike the stereotypical People with Parkinson's PWP (in that most people associate PWP with a visible shaking hand or limbs) I have the 'rigid' type of Parkinson.
Conversely, and confusingly, I have dyskinesia which can be anything from a slight tremor of the hands to an uncontrollable movement of the upper body or lower extremities. And this is affected by the levels of levadopa in my brain.
So firstly Lorraine had me do some excercises with my hands and feet, took some video of me walking and putting on a robe, doing up buttons and then i did a tap test.
Imagine a horizontal piece of A4 paper with 2 dots about 15 cms apart. I was then asked to, using my index finger, to tap the left dot, then the right dot, then repeat as fast as I could. This is with no medication.
LEFT 162 taps
RIGHT 96 taps
I was then given a large dose of sinamet orally (4 x more than normal) and we repeated the excercises. The improvement in motor control was startling. So however was onset of severe dyskenesia (as a side affect of the drug).
We then did the tap test again.
LEFT 201 taps (24% improvement)
RIGHT 226 taps (135% improvement)
The clear message is that I am very responsive to Levodopa, which is great news for my consideration for DBS.
* Some PWP literally cant get up in the morning without sinamet.
