Doug, you're in a horrible spot, but I'm glad you're talking to us here, because so many of us have had the same experience. It breaks my heart that this still happens, when it's so preventable. The ropinirole didn't stop working: it caused the disease to worsen. The good news is that the disease will go back to the way it was, or almost back, once you're stopped the ropinirole and allowed some time for the dopamine receptor system in your body to re-set. (The bad news is that your symptoms will get worse during this withdrawal.)
You will need to take information about augmentation to your doctor, for example the RLS Foundation's Medical Bulletin for Healthcare Providers (see the link in my signature block for instructions on how to access it), Read it first yourself, though, and highlight the appropriate parts before you bring it to your doctor. It is best, since appointments are so short, to have summarized it in words already, so you can show it to him/her while saying "it says here that ..." etc.
Another good publication, for both you and your doctor, is the little blue book called Clinical Management of Restless Legs Syndrome by Lee, Buchfuhrer, Allen and Hening, second edition. In fact, I gave one to one of my doctors once, But nowadays most doctors find all their information online. Nevertheless it's an excellent resource for you. If you look in my signature block link, there's another link to an extract from this book on augmentation.
Some specialists treat augmentation by discontinuing the dopamine-type medication and adding a strong opioid for a week or two, then re-assessing symptoms and prescribing perhaps a combination of anti-convulsant and lower dose of opioid, or even a different dopamine-type med at a lower dose in combination with an anti-convulsant or opioid. Regardless of the post-withdrawal treatment, the only successful way to treat augmentation is to discontinue the dopamine-type medication, at least for a period of time.
The more you know about augmentation and its treatment, the more likely you are to get the right treatment. It may seem odd, but most doctors don't know how to treat WED/RLS or augmentation of it. The recommended first-line treatment for many years has been dopamine agonists, and even though augmentation - a worsening of WED/RLS caused by the very medication that is supposed to be helping it - has been known of for almost 20 years, that knowledge hasn't reached most doctors. So when a patient presents with worsened symptoms, they increase the dose. This strategy works for most other diseases, so it does not occur to them that it could be wrong. even harmful, for WED/RLS patients. The RLS Foundation is working to educate doctors and healthcare providers about the dangers of augmentation, but it's a hard slog.
A growing number of specialists agree that dopamine-type medications, like ropinirole, should no longer be chosen first to treat a new WED/RLS patient, especially if the patient's serum ferritin is lower than 100. Low ferritin has been correlated with worse symptoms, and with increased chance of augmenting on dopamine-type meds. Did you doctor check your iron parameters? Did he tell you what your ferritin concentration is? You should probably supplement with iron if it's lower than 75 or even 100. Be sure to find out the actual number, since some labs will say a level of 20 is normal, and all your doctor will tell you is "it's normal". If you hear that, ask for the actual number.
WED/RLS is essentially a deficiency of iron in certain tissues of the brain. Our hemoglobin levels are usually fine - the blood will steal iron from wherever it can to make sure hemoglobin is adequate - but at the same time the brain is deficient in iron. So when you get iron bloodwork done, be sure to mention that ferritin should be measured. Ferritin is an iron-storage protein; when its levels in the blood are low, there is a deficiency of iron somewhere in the body, even if it's not in the blood. On the other hand, high ferritin doesn't mean there is adequate iron everywhere.
If your doctor is not willing or able to learn about augmentation and its treatment, you can ask for a referral to a specialist - a neurologist who specializes in movement disorders, or a sleep specialist. Or - best option, depending where you live - make an appointment at one of the RLS Quality Care Centers.
Sorry if I've rambled on about this and given you more information than you want. It can be overwhelming, especially when you're being tortured by WED/RLS symptoms and are seriously sleep-deprived. I'm glad you've started fighting your way out of this, and everyone here will help as much as we can; not just with advice (overly wordy, some of it
) but also a lot of love and understanding.