Walking problem after resting


#1
during day time i can walk reasonably well,unaided, and apart from giddyness, don't have much of a problem.

When I wake up during the night to go to the bathroom my walking goes into, a rapid difficult shuffling with difficulty in getting the feet to lift off the ground. If I sit down for a while the problem slowly clears, and my walking slowly recovers.

I have some physio exercizes that were given to me by the day hospital, physio therapist, but the problem seems to be getting worse instead of better.

My medication line up is Stalevo 150mg and stalevo 200mg and RE-Quip XL 8mg +
RE-Quip XL 4mg. The doseage and timing is:

8.30am take 1x Stalevo 200mg + 1 RE-Quip XL 8mg + 1x RE-Quip XL 4mg

12.00 take 1 Stalevo 150mg

4.00pm Take 1 Stalevo 125mg

8pm Take 1 Stalevo 125mg

I have been on this medication pack for just approx 2 years, and have found it to be excelent, and I do not get the tired spells during the day. My original medication was Cinemet and Ropiniroll tablets, and they were notorius for bringing on tired spells.

Any suggestions refgarding this walking problem would be most appreciated

#2
:stuck_out_tongue:I have the same problems and I have had to go and self refer for physio at my health centre.I have been told to try some exercise as my muscles have shrunk. I also have a spur on the heel and they are trying acupuncture to give me some release.Hopefully this will work. Also told to try soft insoles in shoes to help protect feet. Alas it still hasn't helped the morning shuffle and also after rest,I think that's something we will have to contend with. I am on madopar,seligline and ropinirole. Hope this helps.

marymo:stuck_out_tongue:

#3
hi marymo. Thank you for your reply. I think that you are correct in thinking that we just have to grin and bear it. Take it as being one of the "joys" - of - getting older. After a lifetime of hard work, we are told to "enjoy" our retirement. Is Parkinson's one of the perks.

I am lucky, there are other poor souls far worse in health than me. Take good care.

#4
HI there,

Before I put my feet down in the morning I try to rotate feet a bit and it helps a little bit also try podiatrist if you have one at health centre. If i find out anything else will let you know. For now keep them feet walking, just wish they were happy feet. Take care.

Marymo xx:fearful:

#5
Yes, I recognize that problem. It's what I call my early morning shuffle. I take my first meds (Requip and Sinamet) as soon as I wake up at 6.00 so, by the time I have finished my breakfast about 7.30, I am walking reasonably normally (for me)

#6
Hi,

While perhaps a long answer, comparing the times of medication in relation to the 'effective or active arc' of each dose; explained in more detail in the following notes of my regime, may assist towards you finding the answer and balance that suits your particular situation. But please discuss and seek advice from your medical team before and during any regime change.

For what it is worth;

Reading through the various threads on this forum is very useful and most interesting as folk describe their situation and various problems. Hence my flagging up of how physiotherapy is in my view vital in many situations, as is the apparent necessity in striking the right balance in medication strength and timing of each dose, specific to each patient and their lifestyle.

In my personal experience, the biggest factor effecting my daily life is the condition and good health of my spinal column. More specifically, it is the condition of the discs that not only cushion between each vertebrae, but help to protect the central nerve and the nerves extending from it; in a manner, as to not restrict or squeeze upon specific areas of nerve fibres, such that the flow of smooth energy through synapses is encouraged and not inhibited, diffused or misdirected by distorted or damaged cell walls

When you consider the uneven muscle tone aspect in 'the one sideness' aspect in PD, it is hardly surprising that I have to bear all this in mind throughout the whole day. I know that holding a specific position for a period of time will increase and multiply any apparent difficulty, and accordingly I always seek some space around me; just as manoeuvring in a particular fashion or direction enables me improved comfort in mobility. Having a space to move too is very welcome, while the family dog suddenly obstructing me during motion is an annoyance.

Even when sitting at the computer writing or processing photographs, I endeavour to adjust my position as often as possible, while predominately trying to ensure that the weight of my body is not continually compressing the discs in the lower back or causing any prolonged pressure upon specific areas of the spine. Indeed, however annoying or hard to self discipline, I now consciously ask myself, whether I need to get up and take a short break to 'stretch my legs.'
There are of course some floor exercises that I also find very beneficial, to keeping the spine in better trim, by gently stretching it, towards decompressing the discs; as devised through my physiotherapy treatment sessions, that are specific to my situation in damaged discs, nerve tissue and muscle tone imbalances.

Akin to this, I know that relaxing the body while laying horizontal, allows any undesired muscular pressure on my nervous system to be reduced, and as the spine relaxes the discs can effectively re-hydrate, especially during sleep (provided that I have a sufficient, daily intake of water).
Thinking out loud so to speak, just as the human body grows more (when we are young) during sleep, obviously a certain amount of energy in synapses occurs and is required, as our bodies rest, rejuvenate the worn out dehydrated areas of cartilage tissues, etc., that have borne the brunt of the day, or if we awaken to toiletry needs.

Accordingly, and in understanding, that the effective dosage curve of each levodopa drug tablet intake apparently arcs. To achieve 'an as even as possible' dopamine level throughout the day, I consider, that this should include the full twenty-four hours. Thereby, taken three times per day, and allowing a little leeway for the lower level in activity, as I tend not to sleepwalk. The time periods between each equal dose in levodopa, is usually spread accordingly, 7 ½ / 7 ½ / 9 hours or 7 / 7 / 10 hours (if I manage a lay in).

Keeping within these bounds, daily life seems far less problematic than it was when I was first diagnosed. Interestingly, during the summer, I had a brief period when I thought I may need to increase the dosage or change the levodopa formula, however, after a brief trial, I reverted to a lower dose of the Stalevo I had been on for over three and three quater years, taken over the same daily time spans, and the sense of achieving the best balanced for me returned. That said, the sunshine is always good, and I may find my dosage creeping back up, if the winter cold saps up my energy.

Regards Andy