Morning slowness – help and advice needed!

I never was a morning person even before Parkinson’s! However, recently, especially on our holiday in Alcudia I have really been having problems walking not just first thing in the morning but sometimes until lunchtime.  The main issue I have is being unable to walk with a normal stride length but instead taking stuttering short shuffling steps. In the afternoon I am generally (but not always) a lot better to such an extent that I suspect a stranger would be unaware of my condition.

A while back I wrote about how I’d changed my medication regime to try and resolve this and minimise the “off” periods, particularly in the morning, when the Sinemet tablets are wearing off. I am still taking five tablets a day but spreading them out so that the long overnight period without any medication is shortened. Timings are now 6am, 10am, 2pm, 6pm, 11pm. In addition I have made more use of the fast acting dispersible Madopar tablets especially when training or playing in tournaments. These kick in after around 15 minutes and last about an hour and should help get me moving better especially in tournament group stages that tend to be played in the morning! However even with these adjustments I still regularly find myself struggling to walk properly especially in crowded environments like hotel dining rooms! On the other hand once I get to a table tennis table it’s as if I go on to autopilot and I can make movements and play shots instinctively!

One thing that might be having an impact is that although I’ve played table tennis while on holiday in Alcudia it’s been on a Tuesday and Thursday and I’ve really noticed how my symptoms have worsened between Friday and Monday when I’ve not been playing as regularly as at home!  Elaina noticed a similar pattern at Christmas when again the regular sessions were cancelled.

Maybe it really is as simple as doing regular intensive exercise but if any of my PD friends have similar issues and can offer any advice that really would be much appreciated!