Your Local Drug Dealer

If you have Parkinson's disease, you should get to know your friendly drug dealer, also known as your pharmacist. They know more about Parkinson's medications, side effects, as well as food, drug and supplement interactions than even the best Movement Disorder Specialist. Why? Because that's their job.

A local pharmacist named Kirti spoke to our Parkinson's support group. He used words we could all understand and even had a sense of humor. Who knew pharmacists could be funny? They always look so serious behind those partitions. Or maybe they are just working hard. 

Even I learned a few things. (I know you can't believe it. I was surprised too.)

During the question and answer part of his presentation, a lady asked if medications could cause brain fog. He repeated her question so everyone could hear it, using the microphone, but he said brain fart instead. The lady blushed and quickly corrected him. Then he blushed and everyone started giggling like first-graders. (We always try to laugh at our meetings.) 

Another lady asked about calcium supplements for osteoporosis and PD med interactions. He said, do not take more than 600mg of calcium at one time because your body cannot absorb more than that. Also, be sure to spread the doses out during the day. Buying those 1200mg tablets is wasting your money. 

He also stated that many minerals found in supplements (calcium, magnesium, aluminum, iron) can bind to the carbi/levodopa (Sinemet) and may interfere with its absorption. So if that one particular dose of Parkie meds doesn't seem to work as well, did you take it with that multivitamin? It's best to use the two-hour rule: take minerals two-hours before or after taking your Parkie meds. 

Woman's multivitamin

Contains lots of minerals

I guess we better dig out our magnifying glasses and read the fine print on ALL the over-the-counter supplements we take.

A man complained of morning dizziness. He said he takes his Sinemet as soon as he wakes up and then feels lightheaded for an hour or so. The pharmacist explained that our heart rate and blood pressure drop while we sleep and the Sinemet may also cause a blood pressure drop, and that might be the cause of his dizziness. He suggested the man move around some and wait an hour or so before taking the Sinemet. If that doesn't work, tell your Parkie Doctor. 

Another lady complained about the high cost of one of her medicines. She said a one-month supply of rasagiline was over $600. The pharmacist whipped out his smartphone, used his GoodRx.com app, and found her a price of $172 at Walmart. (One of his competitors.) RxOutreach.org has good prices as well. 

He also warned her to avoid foods with tyramine while taking rasagiline or selegiline. Foods like: cured, fermented, air dried meats and fish, aged cheeses, sauerkraut, kimchi, red wine and tap beer. There was an audible groan in the room, right after he said wine and beer. 

Someone else asked if there was a difference between Stalevo versus taking Sinemet and entacapone (Comtan.) He said the only difference is that with Stalevo, it's all in one pill and it costs more. (I'm really starting to like this guy.)

Another person asked about excess saliva and drooling. He said there is a drug that may help dry up the saliva, but that it may also cause constipation, which can already be a problem with Parkinson's. 

Someone asked how to get info if you use a mail-order pharmacy like RxOutreach.org or through the Veterans Administration? He said any pharmacist will gladly answer questions about any medications, including over the counter ones, even if you get them elsewhere. 

Then people began to ask about other non-Parkinson's related medications. Heck, while we had him captive, we might as well get all our questions answered. 

Finally, he was asked if he could recommend a local physician for Parkinson's treatment. His answer was "Just like all Parkinson's medications have side effects, so does living in Yuma. The weather is great, people are friendly, but limited access to specialists is the side effect."

Get to know your local drug dealer, they can answer your questions and who knows, they may even make you laugh.

YumaBev goes to Mexico

The walk over to Mexico

We took a trip to Mexico. The small border town of Algodones is just 25 miles away, so we park on the USA side and just walk over. Once you cross into Mexico, the hawkers start their chants: "Need a Dentist?", "Need Glasses?", "Best prices on drugs" are standard ones. Then there are those who have a sense of humor: "Leather purses, made from real cows" or "Gold chains, almost free" and my favorite "Pretty dresses, for teenager like you".  The sidewalks are uneven, the alleys are narrow and the hawkers sometimes get too close. I'm afraid of falling, so it's stressful.  If I didn't have Parkinson's Disease, I might enjoy it and look around, but I am in a hurry to get what I need and get back to the USA.

Mary's sells everything

Why go there? Because Algodones is filled with Dentists, Pharmacies and Optical shops. You can buy leather goods, jewelry, liquor, pottery, clothes, hats, paintings, etc.  You name it and Algodones probably has it and some of it is actually made in Mexico.  And you can buy all these items cheap, sometimes one tenth of what it would cost in the USA.

Shelves full of medicines

I went to get medication for my Rosacea (red face) and $20 is a much better price than $85. The medicine is made by the same Big Pharma, the only difference is the instructions are in Spanish.

Even Viagra is available

First time visitors are shocked by the Pharmacies, long shelves of medicines and sign boards outside with prices. No prescriptions needed, but there are limits to how much you can bring back to the USA, so we make several trips each year. Some folks go every few weeks.    

Getting in takes minutes, getting out can take hours depending on the time of year. When my step-daughter was here in February, it took 2 1/2 hours to get up to the gate, today there was no line at all.

No line to get out on this trip

It was a hot and slow day in Algodones, even the watch dog was sleeping, but the hawkers were more gregarious than usual, so I didn't stop to look at purses or hats.  I didn't even get a cinnamon roll, the bakery has closed for the summer.

Let sleeping dogs lie, but take a photo, might come in handy

I did go to the Dentist and got some new glasses, but I'll tell you about those adventures another day. After my foreign excursion, what I really wanted was lunch and a nap (and I got both).

Que tenga un excelente día - Have a great day (in Spanish) 

Thank you for reading this story, I hope you enjoyed it. This is just one of a hundred stories in my book, Parkinson's Humor - Funny Stories about My Life with Parkinson's Disease. Please consider purchasing a copy from Amazon or your favorite online book seller.  Thank you and have a Happy Parkie Day!

Pharmacology of Parkinson's Disease

Reading all the fine print on those fact sheets that come with Parkinson's disease medications is confusing and boring, so I decided to use humor to try to explain it.  I got the idea of using farm references by the phonetic pronunciation of Pharmacology (FARM-a-college-ee).


Parkinson's disease is caused when certain neurons in our brain die and quit producing dopamine.  Low dopamine levels cause the signals from our brain to our muscles to get scrambled and produces the erratic movements. Okay, easy enough, just give us dopamine.  The solution sounds simple, but there is a catch: our bodies are very protective of what it lets in the barn (brain) and dopamine can't even get on the farm.  

Dopamine - stay out!!!

The scientists developed levodopa which can get on the farm, but by itself, levodopa causes intense nausea and vomiting and turns into dopamine and still can't get in the barn (brain).  The scientists found that by adding carbidopa to the levodopa, they could prevent it from becoming dopamine and quell the nausea.  Carbidopa is like a Judas Goat, it leads the levodopa past the guard dogs and right into the barn (brain). The combination of carbi/levodopa is called Sinemet.

Sneaks the dopamine in

The problem with Sinemet is that our bodies try to get foreign items out of our bloodstream.  It takes about 45 - 75 minutes from mouth to blood stream and then our efficient blood cleansing organs get rid of it about an hour later, so not much makes it into the barn (3% according to the experts).


The scientists went back to work and found out that if they added another drug called entacapone (Comtan), they could keep the Sinemet in our bloodstream longer and therefore more can be herded in to the barn known as your brain.  The brand name combination of Sinemet and Comtan is called Stalevo.

Herding more into the barn

Comtan has a wonderful side effect of making your urine turn bright yellow, orange or even brown.  This has a tendency to freak out the lab techs when they ask you to pee in a cup.  It is my own personal observation that this yellow stain also creeps into your saliva and perspiration and I am pretty sure that it is staining my teeth as well (just call me mellow yellow).


There is another class of drugs called dopamine agonists. These drugs aren't designed to replace the missing dopamine, they are designed to make the receptors that use dopamine work better without it. It's kind of like dangling a carrot in front of a donkey.  

Agonists act like a carrot and can cause you to act like a donkey

There are 2 main agonists: Ropinirole and pramipexole, known under the brand names of Requip and Mirapex. These drugs do such a good job of stimulating the receptors that they can cause dangerous obsessive or compulsive behaviors such as gambling, uncontrollable shopping or risky sexual activity.  IF you are taking an agonist, you need to be aware of these potentially life altering side effects and find someone you can trust to monitor you. On the up side, agonist's have also been tied to increased creativity.  People start writing poetry or take up painting when they had no interest prior.


Rasagiline (Azilect) and selegiline (Eldepryl) are other drugs that are used in Parkinson's and are in a class of medications called monoamine oxidase (MAO) type B inhibitors.  They work by increasing the amounts of certain natural substances in the brain and act similar to the agonists.  They are often prescribed to recently diagnosed Parkies in an attempt to delay prescribing the Sinemet.

There are many other drugs used to either treat the symptoms of Parkinson's or the side effects of the drugs we take to relieve our symptoms.  

Treatment of Parkinson's consists of easing our symptoms only.  None of the currently available medications will stop the progression or cure it.  Over time, Sinemet causes unpleasant side effects (Parkinson's Drugs Side Effects) and becomes less effective, requiring us to take higher and higher doses, so Doctor's try to reduce the amount of it we take or delay its usage.

The reason Sinemet loses its effectiveness is the brain needs healthy dopamine producing neurons to convert the levodopa into dopamine, and, as the disease progresses, there are less and less neurons to do the converting.


I wrote a song about Sinemet, well, just the lyrics, the music is borrowed.  Have a listen:

Clicking on colored words will open a new window and take you to a different story or link. 

Thank you for reading this story, I hope you enjoyed it. This is just one of a hundred stories in my book, Parkinson's Humor - Funny Stories about My Life with Parkinson's Disease. Please consider purchasing a copy from Amazon.com or your favorite online book seller. Thank you and have a Happy Parkie Day!