My Unusual Case

I am Nicolae Stan (Nicolas) from Bucharest-Romania, 72 years old. I was diagnosed with Parkinson disease (PD) in 2015, almost a year after a severe winter cold that left me without sense of smell. Meanwhile, I recovered partially and I could smell now at least the strong odors.

For better understanding, I will divide the time elapsed since the debut of the disease in two periods: the time passed from the debut of PD until 2018 (1), and the time after 2018 (2).

No major difficulties

During 1, I noticed temperate increasing in legs rigidity, hesitant movement, weakness on my postural verticality, impaired balance, particularly on my left side, with rare cramps/muscle jerks on my left foot, mostly after an hour or more of driving. Contrary to common symptoms in PD, I haven’t experienced constipation and reflux esophagitis, neither hand tremor or difficulty in swallowing, which prompted my gastroenterologist to question the accuracy of my diagnosis (unfortunately, PD has been confirmed later by other two neurologists).

As my neurologist prescribed, I am walking about 4 km a day either outside the house or on my fitness bicycle and I keep exercising on my sport mattress. As medication, I started with ¼ tablet of levodopa/carbidopa 250/25 mg (named Madopar/Isicom in drugs store) 4 times a day, and 2x2 mg of rotigotine medical patch (commercial name=Neupro). In short, until 2018, there were signs that the PD is going on but I haven’t felt major difficulties in my daily life. Consequently, I have intensively traveled inside and outside my country and even went almost every two weekends to skiing and swimming. My gastroenterologist prescribed me colonoscopy and endoscopy: there were minor problems, such as rare internal hemorrhoids and hiatal hernia, respectively, now under medical treatment and scrutiny.

Realizing the progression

Since 2019 (phase 2), I realized that the disease progresses with advance in impaired balance, slower movement, sometimes poor coordination, lower voice. My foot numbs me a few times a day, the constipation became a daily concern, and most disturbing and problematic for an independent movement is severe painful cramps in the abdominal and pelvis areas (intestinal, stomach, bladder, prostate) which for several tens of minutes, 3-4 times a day, left me almost without breath. Cramps usually, but not always, disappear after an increasing dose of levodopa/carbidopa/entacapone which reached now one tablet of 150mg/37,5mg/200 mg, 5 times a day and 2 x 6mg rotigotine patches. I supplement it with gastro medication based on carbocite, motilium, no spa and Nestle fibers.

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