Good News

Day 119
Today is the 110th day of taking a full dose of Azilect and the 2nd day of taking a 1.5 mg dose of Pramipexole (after 68 days on a .75 mg dose).

In the way of a confession, I now must admit a few things which I have previously denied. What I originally told myself was aging is most likely some degree of masking caused by Parkinson's disease. People have commented that this appears to have improved since I have begun taking medication. In addition, as someone who dreamed of being an announcer, I was disgusted to hear how low and slow my voice has gotten. My point is that if you are a friend or family member who has been dancing around these subjects, it is now okay to be direct with me.

I arrived at NYU at 8:35am for a 9:00am appointment and the intern took me in to check my vitals at 8:45! Thank you NYU! My doctor was a little late because her train was held up due to a "suspicious package." Just another day in NYC.

Apparently, my gate has improved by 2 points and my is rigidity is also better (by 2.5 points). I am not certain how this point system works, but I understood the doctor (Jori) when she said, "You are walking like a completely different person!" I did ask about further improvements in my gait and arm swing and we decided to wait and see what happens after a few more weeks on the 1.5 mg dose of pramipexole.

We discussed the possibility of some upcoming clinical trials including the one using the leukemia medication I discussed in yesterday's post. I asked, "Do you have to be further along in the progression of the disease to take part in the clinical study?" She informed that this is not the case. I also answered some questions for research study (which I will complete over the phone this morning).

When asked if Kate had any questions my wife responded, "We have been told what the best case scenario is. What I would like to know is what is the worst case scenario?"  Jori responded, "In John's case, I do not think we are looking at a worse case scenario." Kate responded, "If we were, what would it look like?" Jori's answer was, "20 years down the line he may need a cane or walker." (In fairness, Kate only heard the doctor say walker). Jori reiterated that I was responding well to the medication and at some point, we may have to switch to levodopa. I asked about the dyskinesias associated associated with the use of this drug. The doctors answer was, "While long-term use of levodopa does cause dyskinesias which seem frightening to others, most patients, believe that the results are worth it." Jori also reminded us that I would be a good candidate for DBS surgery. The techniques used to perform this surgery seem to be improving daily and according to my doctor, in many cases the surgery does improve the patient's gait. 

I will close out this post with a few good words about the hospital and my doctor. The level of service provided by the NYU Medical Center is simply amazing. It is possible, that this is simply the level of service that the medical profession should be providing and that years of neglect have caused us all to lower our expectations. Dr Jori Fleisher is truly the best medical professional that I have ever encountered. In Kate's words, "I feel better knowing that you are in such good hands."