Augmentation - Delaying the Inevitable?

Use this forum to discuss any issues associated with Augmentation
Rustsmith
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Augmentation - Delaying the Inevitable?

Postby Rustsmith » Mon Jun 01, 2015 2:39 pm

Anyone who starts using a dopamine agonist (DA) to treat their RLS/WED should accept the fact that some day, they will be faced with the problem of augmentation. Some day might be after only a few days or it could be many years. We cannot predict which because each of us is different.

In my case, I started treatment using pramipexole and augmented on it after about nine months. I started out with 0.25mg in the evening, which worked well. In the end I was taking one 0.25mg pill at lunchtime and another in the evening and still was not maintaining control. My urge-to-move symptoms would start in the late morning and would continue through the rest of the day. My hours of sleep were also being effected.

At that point, my doctor switched me to the Neupro patch. My change from pramipexole to Neupro went very smoothly. The 2mg patch worked for another nine months, but suddenly stopped working. I would wake up an hour after going to sleep with major RLS symptoms in my arms, legs and torso. So my doctor increased the dose to 3mg and the problems resolved themselves.

That increase occurred three months ago and once again, the symptoms are coming back. Not only do I have an increased chance of waking shortly after going to bed with major symptoms, but there is also a background need to move throughout the day. So my doctor gave me the choice, increase the dose to 4mg or switch to methadone.

I realize that this is a clear cut case of augmentation and that I need to get off of DAs. However, I have an unusual situation in that I am a competitive athlete and am planning in running in the USA Track and Field Masters National Championships in late July. As such, I would be subject to drug testing by the same anti-doping agency (USADA) that caught Lance Armstrong. Methadone and all other opiates are on their Banned list of medications, with NO exceptions. If I was on methadone and was tested, I would be banned from competition for the rest of my competitive life.

I have a choice, delay the inevitable by increasing the Neupro dose and probably aggravate my problems when I have to stop using it or give up on my quest to compete again at the national level.

So, even when you know all the facts about DAs and augmentation, sometimes there are situations where doing the "right" thing is not what an RLS/WED patient may choose to do. As a result, I started 4mg last Friday and just hope that it continue to work until August 1.
Steve

Augmentation Evaluation http://bb.rls.org/viewtopic.php?f=4&t=9005

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

Polar Bear
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Re: Augmentation - Delaying the Inevitable?

Postby Polar Bear » Mon Jun 01, 2015 7:51 pm

I am sure you have well thought out your decision and I wish you well.
Betty
http://www.willis-ekbom.org/about-rls-wed/publications
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation

ViewsAskew
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Re: Augmentation - Delaying the Inevitable?

Postby ViewsAskew » Mon Jun 01, 2015 11:38 pm

This disease just isn't fair sometimes. SO sorry you're faced with this difficult decision. Running is so important to you. It's just not right that some drugs are banned with no exemptions. I think I'd start appealing - someone has to make noise or it will never change - maybe that's your next career :-).
Ann - Take what you need, leave the rest

Managing Your RLS

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

Rustsmith
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Re: Augmentation - Delaying the Inevitable?

Postby Rustsmith » Tue Jun 02, 2015 12:16 am

Unfortunately, age groupers like me hold absolutely no sway with respect to the rules. The rules are made for the athlete vying for either the Olympic teams or the national teams heading for the world championships. The opiates are banned because the semi-pros and pros could use them to mask injuries that would otherwise result in a poor performance or cause someone to drop out.

Oh, and I should not forget that these are not USA specific rules, but are supposedly applicable equally to all countries (even if we know that they are only enforced in N. America, the EU and Japan). The Jamaican sprinters got caught last year and the Kenyans have not getting caught at blood doping to a fine art (most of the time).
Steve

Augmentation Evaluation http://bb.rls.org/viewtopic.php?f=4&t=9005

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.

sleepdancer2
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Re: Augmentation - Delaying the Inevitable?

Postby sleepdancer2 » Tue Jun 02, 2015 12:44 am

When I was augmenting, although it seems counter intuitive, when I would step down my dose my symptoms actually improved for a couple weeks. Just wondering if using a TENS Unit could help you step down and/or give you a bit of help to get your through the upcoming event in July. From that high dose. I do hope you plan on weaning carefully off the med. Good luck in the race! I can't imagine having this problem and being able to do what you're doing. You have my respect.
My Augmentation Sleep Video: https://www.youtube.com/watch?v=jE7WA_5c73c

Aipulu
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Re: Augmentation - Delaying the Inevitable?

Postby Aipulu » Fri Jun 19, 2015 4:31 am

Steve, I wish you well in the Track and Field Masters competitions. What is your event? Let us know how you do.

Richard

Rustsmith
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Re: Augmentation - Delaying the Inevitable?

Postby Rustsmith » Fri Jun 19, 2015 5:47 am

Thanks Richard. My best event is 800m, which most runners describe as the most painful distance in running. Last year I also added either the 1500m or the mile.

My goal in all of this is not to win, because I know I am not quite that fast on a national level. I was very happy last year just to not be last (I was exactly in the middle in the 800 last July). My real goal is to run against the clock and let the others drag me along to get a good time that can be used for my national age group ranking. So my goal is to end the year ranked in the top 25. I managed to do that last year in the 800 and almost did it in the mile.
Steve

Augmentation Evaluation http://bb.rls.org/viewtopic.php?f=4&t=9005

Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.


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