|
Introduction
 Treatment
involves an operation to make a small opening in the abdomen
so that a tube can be passed into the bowel. The tube is
then connected to a portable pump that is worn during the
day and feeds levodopa/carbidopa directly into the bowel.
This means that the medication bypasses the stomach,
where most of the levodopa absorption problems occur, and
therefore has a better chance of controlling symptoms. The
pump is disconnected at bedtime but tablets are available
to manage troublesome night-time symptoms if needed.
Treatment Plan
Click
Here to download Duodopa Treatment Plan
Test Treatment
In order to test Duodopa, a nasointestinal tube is used
for a test period of approximately 3-5 days. The nasointestinal
tube is inserted with the help of x-ray or gastroscope.
Advantages of using the nasointestinal
tube
- Does not need an operation
- Medication can be discontinued if the treatment is not
suitable
During the test period, the continual infusion dose of
Duodopa will be closely monitored by the Solvay Nurse and
the ward staff.
The rate at which Duodopa is infused will be
calculated from the patient's initial dose of oral medication
before admission. This will be changed throughout the test
period according to the severity of symptoms.
This will be continually assessed until the patient has
reached their best therapy treatment, which can take anything
from 3-5 days in the hospital.
Permanent Treatment
After the test period has been completed, it will then
be decided by the patient and the Neurologist whether to
continue with permanent Duodopa therapy.
This will involve a tube (PEG) being inserted into the
patient’s stomach with the help of a gastroscope (a
thin, lighted tube used to view the inside of the stomach)
whilst under light sedation/local anaesthesia.
An 'inner tube' is put through the tube (PEG) and pushed
through the pylorus (the muscular valve separating the stomach
from the small intestine). Treatment will continue once
the PEG has been inserted.
The wound site surrounding the PEG tube will require a
dressing initially but will heal and need just regular cleaning
with soap and water and thorough drying (further information
can be found in the Patient Information booklet).
The treatment will then continue via the PEG and pump.
The patient will be discharged once all arrangements have
been made and both the patient and carer feel completely
confident and competent in using the Duodopa therapy
pump system.
Use of Duodopa following PEG Surgery
Click
here to view and download a wallchart on your daily
routine following PEG surgery.
Once Home
Home Care Delivery
All supplies needed for the Duodopa therapy
are provided by a home delivery service, Healthcare at Home.
They will supply on a monthly basis the Duodopa cassettes
(which require refrigeration until they are used) and all
other equipment required.
Once the patient has been referred for Duodopa treatment,
Healthcare at Home (with the patient's consent) will be
informed of the date therapy is to commence and the discharge
home date. They will contact the patient to arrange a suitable
date for the medication and equipment to be delivered to
their home address.
Throughout treatment, a Solvay Nurse Advisor will be able
to liaise between the patient and Healthcare at Home if
any problems are experienced with deliveries.
Contact telephone number for Healthcare at Home:
0870 600 1542
Contact telephone number for the Solvay Nurse Advisor 24
hr Helpline:
0800 458 4410
|
