The doctor says the worse you sleep, the more likely you are to hallucinate under the influence of the anti-parkinson meds. The patient took a sleeping pill a friend gave him, a valium, and slept like a baby. The physician explains those drugs are fine for the short-term. Taken repeatedly they lose their efficacy, and over time people become dependent on them; without the medication they feel anxious and irritable. Being depressants, people with Parkinson’s disease should avoid drugs that depress the nervous system; they tend to worsen the depression that accompanies PD.
He’s forgetting a lot of things. He had a girlfriend who cooked for him, but she left him.
“And you’ve forgotten her.” The doctor comments. I can’t tell if he smiles.
He doesn’t want to take Seroquel, it gives him a headache. The doctor urges him to give the medication a chance, he has not yet found the right dose that will help him sleep. The patient comments his mother takes it also, and she hallucinates all the time. Explaining the medication is given to decrease hallucinations and promote sleep, the physician says doses can range from 25 mg up to 600 mg. Everyone has to discover their own requirement, between getting a solid night’s sleep, and being excessively sleepy the following morning, or not sleeping at all. He asks whether the drug comes in a generic, and the doctor nods, though the generic quetiapine fails to be listed among his choices to prescribe.
He isn’t able to work. His mind is failing and he has noticeable tremor in his left hand. The hand flails about the physician’s desk like a dying fish. He has to wait two years until he can apply for complete disability though he was diagnosed with PD a year ago. Concerned about paying his bills, he doesn’t want to declare bankruptcy. The Seroquel is expensive.
The doctor types while he asks the patient what sorts of things he does during the day. Wearing a baseball cap and white athletic shoes, the patient says he rides his bike in the neighborhood. The doctor nods commending the activity telling him he needs to exercise daily.
He drives two and a half hours from Sebring for his appointments, but he’s content to do so, it’s only every six months. As he leaves the doctor assesses the muscles in his upper body, noting they feel fluid. In the hallway he walks with a bilateral arm swing, if it wasn’t for the tremor of his left hand he might appear normal.