<h1>Sometimes we take action. Sometimes we take pills.</h1>

I have always wondered if I would suffer the "wearing off" effect and now seven years post diagnosis I am experiencing wearing off, thanks to 6 years of levodopa therapy. Wearing off is the term used to describe the time when the beneficial effects of a dose of levodopa diminish before the next dose is due. Symptoms of Parkinson's that have been depressed by the levodopa begin to return, for me, about an hour before my next dose.

This wearing off phenomenon is the result of the further loss of dopamine producing cells causing the dopamine levels in the brain to decline, making it harder for each dose of levodopa to suppress symptoms.

I take 4 doses of L-dopa and mirapex daily. A graph of the effects of the medication would show a bell curve, sort of. I take the pill and it takes about a half to one hour for its effects to become fully effective, followed by 2 - 3 hours of few, or no symptoms, then one-half to one hour of wearing off when they begin to re-emerge. I take advantage of the approximately 2 - 3 hours of grace; although, if I get involved in physical labor, the medication will wear off sooner.

PD is a designer problem. No two victims are consumed by it at the same rate. I have read of victims experiencing wearing off after 2 - 3 years, or the medication can be effective for 5 or more years.

In my case, the wearing off effect started not long ago but appears to be subject to the amount of rest I get and whether or not I have performed physical work. So far, the pill cycle of "starting to be effective - topping off - wearing off" doesn't affect me too radically. I know it will get worse, but I can take anything PD can throw at me (knock on wood).

Some people delay taking medication to avoid the cycle, but, even though I feel my PD timetable is humming along, I wouldn't change anything. I chose to start medication early, so I could enjoy those years when I was relatively young and I would make that choice again in a heartbeat.

Seriously though, I have to take my 3 o'clock dose now. It has taken me twice the amount of time as is usual to type these few paragraphs. Why? because I am in a wearing off period and my fingers have a life all their own. At rest, they will type random letters over and over and I have to go back to erase them or repair the damage to the words into which they have inserted a letter. It's a drag but as I said there is nothing PD can hand me that I can't deal with......yet.

Some times I think God writes humorous plays which nobody finds funny. With that thought, I am leaving the desktop to take another pill.