I’ve given the weekly ropinirole diary a bit of a rest of late, not least because it was getting very tedious. I think there may have been some benefit at 4mg, but it hadn’t sorted out the dystonia in my left foot (a desirable target) nor given me confidence in my ability to tie shoelaces (a measure of sorts). I was also failing the automatic watch test. It hasn’t noticeably changed my personality yet, so that much is good.
As I had a regular consultant’s appointment a couple of days ago, I decided to bring the subject up there. I was slightly surprised to find myself meeting a new consultant – apparently the previous incumbent had decided to spend less time in my local hospital (I understand that he’s based 40 or so miles away), and so I have a new consultant. Naturally, the appointment turned into a sort of introductory session where she went over some old ground, as was only right and proper.
She wanted to know why I had chosen to try ropinirole rather than levadopa; was it that I was concerned about scares that levadopa made the Parkinson’s worse? I wasn’t aware of any such scare. My reasons were more to do with the apparent limited timescale that levadopa works without side effects. She didn’t seem completely convinced, but, equally, she didn’t offer any counter arguments.
We moved onto the dosage of my ropinirole. How many tablets was I taking daily? One – the prolonged release version, containing 4mg. She evidently would have preferred it if I was on the multi-tablet regime, but accepted my argument that I’m not very good at remembering to take them. She even admitted that the one tablet she takes is quite often forgotten. The reason it is “better” to be on the multiple tablet regime is that it is easier to “titrate” the dosage – basically, the simpler tablets are available in smaller increments. (Titration is a means of adding small amounts of something to determine the minimum quantity required to achieve a desired effect. It is done in chemistry using a burette – a long, calibrated glass tube with a tap at the bottom). But if I forget tablets at random, the titration will not work. So we’re going up 2 mg.
My agreeable GP has already supplied me with a prescription. I’ll start tomorrow… and the new consultant says that the results should be observable within a few days, possibly a week.