First give yourself a huge pat on the back.
If you are running a business and laying bricks then you are successfully managing your pd
Most drug regimes tend to ignore the later hours of the day as we are expected to sleep though this period so could be why you are wearing off.
I have never used Madopar dispersible so cant comment from experience. My comment is to beware overuse if it causes dyskinesia as I know of several more advanced cases that have been affected. Dyskinesia is a side effect so can be reversed.
Here's what I do:
I find that to start the day I need 2 doses of sinemet taken at approx 7am and 9.30. I tend to think of dopamine like insulin ie its necessity is based on activity inc. thought sometimes!
If I get up early to go fishing I will take a pill at say 5pm to work by 6am. When taken early I find that the need for my subsequent pills even out during the day. I have approximate pill times if i am wearing off within a hour of my next pill time I take a pill early. I find that waiting causes a deficit; like running out of fuel in a car makes the car harder to restart so I keep the tank topped up.
I find the best way to take levodopa in my case sinemet or stalevo is;
plenty water or better still with fizzy pop as well and followed by something sweet eg a banana, biscuit, mars bar etc. this i believe gets the pill into the duodenum where it is absorbed along with sugars.
A banana etc often works if the sinemet doesnt appear to be kicking in particularly on an empty stomach. On a full stomach caffeine in the form of a strong coffee with sugar or a cheap caffeine drink work well.
Bananas and coffee replace madopar dispersible for me.
This is not a mad idea I had, I was told about this sometime ago by fellow pwp and have discussed it with my neuro who already knew about it. The coffee I believe works because it encourages gastric emptying, hence why a coffee is offered in a restaurant, therefore getting the drug to the duodenum. All I have done is refined it to suit my lifestyle.
If the banana coffee trick doesnt work I find there is usually a reason for this such as:
Lack of sleep or overtired
An underlying illness that has not shown eg a cold
Anything that affects the gut, dont forget the pd gut is slower than normal.
Taking all the above into account if after 2 hours my pill hasn't kicked in I assume that it hasnt worked, probably due to stress exacerbated by the need for it to start working and I take another. My choice.
Since I have adopted this strategy I have not increased my pills from 5 stalevo since 2012 and even then the extra 5th stalevo was part of the necessity to replace the withdrawal of mirapexin.
Other things that help;
Rest when you need it
Dont try to do an activity when worn off, drink coffee and put feet up; once you are back on you will sort things out in 2 mins.
Be realistic. You have got PD it isnt going away
if you accept the changes it makes to you you can find a way to overcome the problems.
THERE IS ALWAYS A WAY.
Have a contingency plan if you wear off eg:
Always take a trolley into a supermarket; it doubles as a zimmer
If you are in difficulty always have back up you can ring for help.
You are the most important thing; if I go fishing and cant get my tackle back to the car I hide it and come back later for it. Tackle I can buy again.....
i believe if I had adopted this strategy earlier I may have realised that the wearing off of pills could be due to several factors and that by waiting and investigating I have found the answer and have got back to "normal"
Dont be afraid to explain your pd when necessary and ask for help when needed.
I have never had a negative response to asking for help.
That's the way I do it .
Hope it helps somebody.