Today is follow-up number three with Dr E.
At too-close-to-16.00 I open the door to the mental health unit with only one misturn of the handle – this is smooth and practised by my standards.
The appointment is cheery and brief. I explain that I didn’t get along with the ‘booster’ dexamfetamine sulfate pills, for which Dr E is apologetic (needlessly so, I assure her – it wasn’t exactly traumatic).
I suggest that we try topping me up with more Elvanse in the afternoon instead. I’m expecting pushback, but it seems to make sense to Dr E, although she says she’s not done it before.
I counter objections that she hasn’t yet voiced: My heart rate is fine. I’m keeping an eye on my weight (this is finally true). I have tried taking my pills later in the day, and I have not had trouble sleeping. 
She seems happy, rather than concerned, that I’ve been experimenting, even when I mention that I know how to dissolve and split up doses of Elvanse if the booster is too much for me (although in the end I chicken out and don’t mention my short-lived increased-dose experiment).
As the pills only come in 30mg, 50mg and 70mg, I will be prescribed 30mg, which takes me over the BNF recommended daily maximum of 70mg. Dr E makes sure I understand this (I do, of course – I’ve done so much bloody reading on the subject).
Without much further ado (I tell Dr E that my heart rate is still fine, my blood pressure is taken and pronounced satisfactory, and we scout around for a scale before settling on my home-recorded weight) I am given the prescription and told that, should the pharmacy make any noises about the BNF limits, they can call her.
All in all, I’d call that a success. Now it remains to see what good the 30mg afternoon dose of Elvanse will do me.
