Infection and exacerbation.

[Rev--Jenie-Bogard]

  I've recently been diagnosed with DRD, taking 50/200 Sinemet tid for reallly good mobility.  w/o Sinemet I cannot stand or walk.  Docs say I'm somewhat atypical, perhaps a slightly different biochemical defect.  I've recently been discharged from the hospital due to a lung infection.  In the past week I have not been able to stand or walk, and even lost fine motor control due to extreme tremors for a couple of days.  I couldn;t write or feed myself.  I began to lose bladder function again.  All my pre-treatment symptoms returned and then some.  I've been on heavy duty meds (steroids, antibiotics and inhalers) for a week, but am not regaining the effects of the SInemet even now that I'm feeling and breathing better.  I'm worried that I won't get better again, though the docs here say to sit tight. But how long will it take?  They said this can happen with Parkinson's disease, too.  Is there anything that I can do to try and help myself get better?  I'm taking more time off work, both because I still feel exhausted and also don't particularly know how to face the world in a wheelchair again.  The day I ended up in the ER due to shortness of breath, I had also been out riding horses earlier.  I was coughing, but felt OK.  My legs simply stopped workingthat evening.   I'm scared.  Please help if you can.
  Rev. Jennie Bogard
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Sorry about taking so long to respond.
I see a lot of people with Parkinson's disease (fewer with DRD, but many with other syndromes of dystonia). It is quite common for someone with a chronic neurologic disease (PD, dystonia, epilepsy, recovered stroke, etc) to experience transient worsening when there is some other illness or severe stressor going on.
In fact, when PD patients call me and tell me there has been a sudden change in their mobility, I question what triggered it - it's almost always a medication change or an acute infectious illness. The underlying disease doesn't progress fast enough to cause acute changes in motor ability. Likewise, in DRD, worsening must indicate the presence of something else.
It takes a while (sometimes many weeks) but people recover to baseline, if the acute problem truly was something like an infection.
You're on a number of medications to treat the short-term infection that may influence the bioavailability of levodopa to be converted to dopamine, or the ability of the relevant transport systems and enzymes involved in the biochemical process.
I hope this helps. As you know, this isn't the place for actual medical advice - the intent is to provide educational information. CCF MD mdf.