The Beijing patient is male, aged 66 years old, and has been ill for 10 years.
Disease type: Parkinson's disease.
Past medical history: On April 17, 2018, he performed the operation of a bilateral rechargeable computer pacemaker at Beijing Tiantan Hospital.
Current medication status: Medopa shares two and a half tablets a day.
Postoperative program control: the effect of the operation is not satisfactory in one year, debugging twelve times, each time the effect is debugged, the effect is good and bad, the last pulse width is 90, and the voltage is 350w.
At present, the main symptoms: walking has been difficult after surgery, taking medicine is not very effective, and the first step can never be opened.
Questions to be consulted: Please ask the professor I want to halve the tablets of Medoba can be, because Payou said that more than two pieces of Medoba people will not be able to resist, and help ask rotigotin patch can work well? Why don't the hospitals start, there are no hospitals in Beijing, only pharmacies have them. Thank you Professor Lee.
Professor Li Weiguo answered:
The individual differences in Parkinson's disease are very obvious, the symptoms of each patient are different, the sensitivity of the drug is not the same, the dosage of the drug is not the same, for the patient after surgery, the parameters of this program control of each patient are also different, and the contact points of the program control are also different. This is determined by the clinical experience of the surgeon and the program control physician.
He wanted to ask, is it okay if he wants to halve the film? Because she said that she had heard that some Payou said that there were more than two pieces, this did not work.
In fact, it is not, because in the later stage, it is indeed necessary to increase the dose of the drug. Then the current use of levodopa preparation medopa may not be particularly appropriate. It should still be a combination, you can increase the agonist, rotigotine can use, this is no problem, but the use is still a small dose, such as starting from two milligrams and gradually increasing to four milligrams. Fluctuations in this symptom can be reduced. The effect is still good.
Why doesn't the hospital start up? There are no hospitals in Beijing, only pharmacies. Because this is a big guideline and policy of the state, at present, from the perspective of medical reform, medicine is separated, and medicine is separated, which is a trend and direction of development.
Like Shandong University Qilu Hospital, the current drugs in our hospital are also decreasing, and many drugs are put into pharmacies. In fact, he is the same for medical insurance, and the drugs in the pharmacy can also be reimbursed. So we also have a lot of patients are to the pharmacy to buy drugs, may be the future patients will gradually adapt to this situation of going to the pharmacy to buy drugs, the hospital is to carry out some basic medical behavior, and there is no business of some drugs, so it may not be too convenient for patients. But this is a big trend direction, because basically some large medical centers abroad use this model.
