Best London Consultant?

[rkatt]

Am I right in thinking Prof Matthew Walker is regarded as the best RLS doctor in London? I'm asking because I have a GP appointment and may have to ask for a referral.

I've had severe RLS for a long time, tenuously controlled since 2021 by Buphrenorphine. My symptoms suddenly deteriorated a few months ago. I was on holiday at the time, which shocked me as they usually lessen then, sometimes allowing me to cut down very slightly.

I can't work out why this was. I had a severe but short term flu like illness before leaving. That can't be a player. I am gluten allergic but in Greece bread didn't seem to affect me so I ate it every day. When I got back I had a severe attack of IBS, with stomach pains and lassitude. But that's cleared up. I'm mystified and worried.

The reason I might need a referral is that I want the doc to increase the dose of B. I have a suspicion she won't be able to because my previous consultant, Dr Guy Lechziner, mentioned 600mcg in his letter to the Practice. He was just saying that's the starting dose in the USA, but you know how phobic doctors are about this actually relatively harmless opioid.

I've tried all other meds. Gabas, Tramadol, Targinact and the rightfully dreaded Pramipexole.

I'd be grateful for your thoughts.

[Joolsg]

You might be better going back to Guy Leschziner. Prof. Walker is good and does prescribe Buprenorphine BUT he has been known to blame it for tooth decay. As you've been on Buprenorphine for 3 years that may not be a problem.What may have changed? IBS can cause malabsorption of iron so levels may have dropped. Also Covid can trigger/worsen RLS and that may be what your illness was.

Finally, the brand may have changed.

I get 24/7 cover with Accord brand but I get severe RLS for 2 hours every night with other brands.

As you know 600mcg is below average so you could increase.

[rkatt in reply to Joolsg]

Thanks Jools. Yes, I can increase, but I'm worried the Practice will make trouble. Hope it'll be okay. I've had nearly four years of fairly normal sleep, so the idea of going back into the horror is awful. My pharmacy only get Tephine, alas, but I'll explore other options.

Tooth decay!!

[Joolsg in reply to rkatt]

I just discussed that this afternoon at my dentist. No sign of tooth decay for me after 3 years. I do get dry mouth but use dry mouth spray & mouthwash.I am positive that the UK will start to see the light in the next 2 years. Especially if the producer of Mr Bates is successful in getting a docudrama made about the ICD epidemic on DAs. Together with the hundreds of successful legal actions against UK doctors.