Martin has been attending the Southern General since his diagnosis, and has received good quality care there. It's a bit of a trek from here, with the journey taking 40-60 minutes by car, but the staff have known Martin for the 19 years since his diagnosis.
Martin was seen first by the nurse, who spent time with him carrying out an assessment of his current condition, and the progression of his condition. He was fairly "off" when he arrived, and was asked to do things such as tap his toes and heels on the floor, move his fingers, stand, walk, and was asked about his tremor, dyskinesia and freezing. She checked his previous score for movement, and appeared quite astonished, saying that she had never seen a score as high as that before. I was quite surprised, but Martin explained that he had been very "off" during that visit. On this occasion, his score showed some improvement.
We were then shown into Dr Grosset's office - Dr Katherine Grosset, rather than Dr Donald Grosset. Donald is the Consultant neurologist who has been treating Martin, while Katherine is his wife, and also has a special interest in neurology. She discussed the options for more advanced treatment, focusing particularly upon the Apo-Go Pump.
This pump delivers apomorphine, a strong dopamine agonist (earlier posts about Martin's medication will explain what a dopamine agonist does, if needed). It can be helpful for people where the oral medication is no longer sufficiently controlling the symptoms. Parkinson's UK suggests that it mat be help if you:
- have sudden or unpredictable changes in your symptoms
- have severe 'off' periods that aren't controlled by other Parkinson's medication
It's a portable, battery driven syringe driver which delivers the medication by controlled release through a daily injection. Martin would still have to take tablets in addition to this, but it should reduce the number of tablets taken, and deliver the apomorphine in such a way that he has fewer fluctuations in his condition.
There are potential drawbacks. The needle must be inserted in a different place every day.
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