Jessie Von Leer was seen in followup for Parkinson's disease. She states that she still feels somewhat slow on standing and walking. However, she is now able to walk without using a cane. Her main difficulty is each dose of Sinemet does not last until her next dose. She takes Sinemet 25/100 one and one half tablets at 9 AM and 3 PM then one tablet at 9 PM and 3 AM. She states that her Parkinsonian symptoms, including her gait ability seemed to have improved after taking each dose of Sinemet, but then these symptoms worsen before the next dose of Sinemet. She states that she is having no difficulty with Sinemet.
ROS: Gastrointestinal - She is not having nausea, diarrhea, or other gastrointestinal side effects with Sinemet. Neurological …show more content…
She converses appropriately. She is in no acute distress. Blood pressure 120/82. Pulse is 66 and regular. Weight 192 pounds. She has a mildly masked appearance of her face at rest. Her face continues symmetric at rest with good strength with smiling, keeping her eyes closed against resistance, and wrinkling her forehead bilaterally. She has good strength of her extremities. She has only mild cogwheel rigidity of her wrists and elbows. She had only a minimal resting tremor of her right hand. She did not have any tremor, did not have any tremor of her left. The tremor of her right hand resolved with using the right hand. She has mild bradykinesia on standing, but is able to stand on her own. She walks with a mildly broadened base of her gait and with only mild bradykinesia of walking. She is not shuffling her feet when walking. She has only mild en bloc turning and mildly decreased posture stability reflexes. She is still able to walk, thought, including turning without losing her balance.
IMPRESSION: Parkinson's disease. Her Parkinsonian symptoms are improving, but each dose of Sinemet does not last to the next dose. The pain she is having in the right foot may be more due to difficulty within the right foot itself, rather than
ROS: Gastrointestinal - She is not having nausea, diarrhea, or other gastrointestinal side effects with Sinemet. Neurological …show more content…
She converses appropriately. She is in no acute distress. Blood pressure 120/82. Pulse is 66 and regular. Weight 192 pounds. She has a mildly masked appearance of her face at rest. Her face continues symmetric at rest with good strength with smiling, keeping her eyes closed against resistance, and wrinkling her forehead bilaterally. She has good strength of her extremities. She has only mild cogwheel rigidity of her wrists and elbows. She had only a minimal resting tremor of her right hand. She did not have any tremor, did not have any tremor of her left. The tremor of her right hand resolved with using the right hand. She has mild bradykinesia on standing, but is able to stand on her own. She walks with a mildly broadened base of her gait and with only mild bradykinesia of walking. She is not shuffling her feet when walking. She has only mild en bloc turning and mildly decreased posture stability reflexes. She is still able to walk, thought, including turning without losing her balance.
IMPRESSION: Parkinson's disease. Her Parkinsonian symptoms are improving, but each dose of Sinemet does not last to the next dose. The pain she is having in the right foot may be more due to difficulty within the right foot itself, rather than