His life was unpredictable because he never knew when the symptoms would appear. He also needed to take four pills every three hours.
Levodopa has been on the market since 1969. It's a cheap and reliable first line of treatment for many. But as the disease progresses, Levodopa often wears off sooner.
Bob's situation is not uncommon for many Parkinson's patients so when he had the opportunity to join a clinical trial at Cleveland Clinic testing a new way to deliver the drug, he took the chance.
The device is called Levodopa Carbidopa Intestinal Gel pump, or LCIG. It's been used in Europe for over a decade, but just now being tested here.
Dr. Hubert Fernandez is the head of Movement Disorders at the Center for Neurological Restoration at Cleveland Clinic. Bob is one of three of his patients testing the pump.
It works by surgically inserting a tube into the intestines. Similar to a feeding tube but smaller. The tube is attached to a pump device and the Levodopa is contained in a gel pack.
"Imagine your life taking three quarters of a pill every one and a half hours for sixteen, eighteen or twenty hours of the day. Your entire existence revolves around taking medications and that is not practical," Dr. Fernandez says.
Bob's wife Carole describes life like falling off a cliff. One moment Bob's fine and the next his Parkinson symptoms claim his mobility.
However, when Bob was given the pump Carole witnessed a dramatic change in just twenty minutes.
"He got up and walked out into the hall and everyone was like whoa! Usually with oral medication it took a good hour hour and a half to get function," Carole remembers.
Bob's quality of life has improved as well. He wears the pump during his waking hours and shuts it off when he goes to bed. The steady drip of medication keeps his symptoms in check allowing him to make plans and stick to them.
The pump is sometimes cumbersome and difficult to conceal so he named it "Thorn." But it's a thorn in his side he'll happily stick to.
The final testing phases of the pump are complete and then the FDA will review the findings. Dr. Fernandez hopes the pump will be available to patients in the next year or two.
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