THat was my "adaptation nurse" for the injection lessons! I won't say her name here , but isn't she great! She is truly "one of them" who is "one of us"; and there are not many of "them who truly understand us" around. Not even my neuro (as his own admission); but he was the one to get me into the program and was relatively sure that I could "hack it", even though i've told him that agonists are "not my cup of tea".
Apomorphine is the most potent D agonist known. THe structure of Dopa is conserved in the structure of apomorphine ( incorporating a "frozen" Dopamine conformer-like structure, rather than a "freely rotating" one ,such as dopamine itself) It just has some more in the way of lipophilicity or a structure which is brain penetrable. SO a small amount of intact apomorphine that makes it to the brain because you are injecting it and it doesn't get broken down in the gut or torn apart by first pass liver enzymatic degradation goes directly into the brain , reaches the brainstem and "Does it's job".
I am renewed with the idea that there might be some other "optimal" D agonist that exists but hasn't been found yet. Remember, we are really looking at the future prevention of PD rather than saving (and by "saving" i mean giving a PWP more, better years with the disease) those who have PD now. Once prevention is figured out, all that will remain us; those who have run the course with PD and can't be saved. Maybe someday there will be a monument in Washington with the statement of the fact that there were millions of us who "didn't make it", while waiting for the cure to PD, punctuated with the address that PD is a thing of the past, and the names of those who cured it, and the year the disease left us alone, and a quote by those who cured it, maintaining that it was always just a matter of time, but the above fought the good fight and never made it, but it was because of their sacrifices that your father, your mother , your brother, sister etc., won't ever have to think of this abominable disease again. FOREVER.
So there are cell constructions to be made and tested yet, ones that are genetically so close to the patient that rejection and control of growth and ultimately the correct ability to do the job of curing PD is accomplished. There are still pharmaceuticals awaiting to be born; ones to further attenuate the suffering of PD, and there will be an "intermediate" time to get the cure polished up so that it works every time, almost like a vaccine for PD, that stops PD in it's tracks before it gets started, and it is banished forever from this globe. Small steps for a single human, but large gains in the preservation of a happy, healthy, human species. cs