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DBS can regain a quality of life

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In researching for this week’s column, I ran across an article on the Internet that had run in the Las Vegas Review Journal back in 2013 that told the story of other DBS patients. The story was written by reporter Paul Harasim.

I thought you might like to hear another individual’s comments about undergoing the brain surgery that is involved with installing the Deep Brain Stimulation apparatus.

That person was Kip Smith, a 59-year-old man who worked as a meteorologist with the National Oceanic and Atmospheric Administration. He frequently couldn’t sleep more than 30 minutes a night no matter what he did. He couldn’t keep his legs from trembling or escape the spasms that jerked him awake.

His days were often filled with other frustrations. The right-handed Smith’s right shoulder became so frozen in place, he could no longer write or eat with his right hand. Muscles in his right leg would stiffen so much that walking only 100 feet caused such cramping in his right foot that he’d have to stop to take a break.

He said he came to the conclusion that he must do something drastic if he wanted to have any remaining quality of life. The drastic step he took was to undergo the DBS surgery.

Following surgery, he could take long walks to stay in shape. The tremors that made it nearly impossible to work on a computer were no longer evident. His legs relaxed at night so he could sleep. Work was no longer a struggle. He did not require any medications.

The only hint that something was off with Smith was his speech, which was a tad slow.

His surgery was performed at Sunrise Hospital and Medical Center in Las Vegas.

At that time, most neurologists didn’t recommend the surgery, which carried risks, until several years after a patient has been diagnosed and after medications have lost their effectiveness.

The surgery was approved by the Food and Drug Administration in 2013 as a treatment for Parkinson’s. It is not a cure. As the disease progresses, doctors regulate, without further surgery, impulses to the target areas of the brain which block the impulses that cause tremors. It is not known how long the procedure can be effective because the procedure is relatively new.

In my case, I had the surgery in 2011 and I have no reservations about that decision. I was 58 years old and worked until I was 70. Now, four years later, I am feeling an advancement in my symptoms. My doctor at the Mayo Clinic has been able to control my symptoms by the DBS adjustments and medication.

Dr. Eric Farbman, a neurologist at the University of Nevada School of Medicine, said he’s not against DBS surgery but is cautious in recommending it to patients early in the progression of Parkinson’s.

“If I can give someone relief with three pills, is it worth the risk of doing brain surgery?” he said.

“The idea of someone drilling holes in your head,” neurologist Beth Chang said, “would give anyone pause.”

Although the risk of death from the procedure is less than one percent, there are also the dangers of strokes, bleeding inside the brain, seizures, infection and impaired speech.

Of the 90 Farbman patients who had the surgery, one had complications. That patient suffered a small stroke, but the surgery still helped him.

Incidentally, the current edition of AARP Magazine has an article about upgrades in the DBS implants.

Surgically implanted deep brain stimulators use electrical impulses to improve symptoms such as tremor and rigidity. But these stimulators cannot be directly monitored, so results are measured by the subjective reports of patients.

In 2020, the Food and Drug Administration approved Medtronic’s new stimulator with BrainSense technology, which can sense and record the brain’s electrical signals. Its ADAPT-PD trial is now testing whether the Brain-Sense recordings can be used to adjust stimulation automatically.

Well, that’s all for this week. I hope these past two columns have been helpful for those of you who had questions about Parkinson’s.